Sami Karoui and colleagues from the La Rabta Hospital in Tunis, Tunisia, report that the PPI pantoprazole reduces the frequency and severity of gastroesophagopharyngeal acid reflux in patients who have chronic pharyngitis and/or laryngitis. In addition, almost all pH-metric parameters assessed in their study improved after treatment.

Chronic pharyngitis and laryngitis are ear, nose and throat (ENT) manifestations of GERD that are associated with pathological exposure of the proximal esophagus to acid. However, it is often difficult to establish whether ENT symptoms are caused by GERD because many patients do not suffer from heartburn or acid regurgitation or lack endoscopic evidence of reflux esophagitis.

Karoui et al. used dual-channel 24 h pH monitoring to evaluate the effect of pantoprazole (80 mg for 8 weeks) on clinical outcomes and pH in 33 patients who had a confirmed diagnosis of chronic pharyngitis and/or laryngitis that was attributed to GERD. The pH was recorded before and 1 week after treatment.

Treatment led to clinical improvement in 51.5% of patients. Pharyngitis disappeared in 58.3% of cases and laryngitis in 63.3% of cases. Proximal and distal esophageal pH normalized in two-thirds of patients. The proximal and distal acid exposure time, reflux episodes and reflux episodes lasting longer than 5 min all improved significantly; only the duration of the longest proximal and distal reflux event and the number of nocturnal distal reflux events failed to improve markedly.