Efficacy of rabeprazole-based therapy in laryngopharyngeal reflux disease: a prospective comparative study

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Background: Laryngopharyngeal reflux disease (LPRD) is a common condition presenting to otolaryngology clinics, yet the role of proton pump inhibitors in treatment remains controversial. This study aimed to evaluate the efficacy of proton pump inhibitor therapy combined with alginate and lifestyle modifications in managing LPRD. Methods: A prospective, comparative interventional study was conducted at a tertiary care hospital from August 2023 to April 2025. One hundred twenty patients aged 18-80 years with clinically diagnosed LPRD (Reflux Symptom Index ≥13, Reflux Finding Score ≥7) were randomly assigned to case and control groups (n=60 each). The case group received rabeprazole 20 mg twice daily, domperidone 10 mg twice daily, alginate 10 ml three times daily, and lifestyle modifications. The control group received identical treatment except rabeprazole. Primary outcomes were changes in RSI and RFS after 6 weeks of treatment. Statistical significance was evaluated with p-values. Results: Both groups showed significant baseline comparability. After 6 weeks, the case group demonstrated superior improvement compared to controls. Mean RSI decreased from 20.6±3.5 to 10.5±3.2 in the case group versus 20.8±3.7 to 12.8±2.5 in controls (p<0.001). Mean RFS improved from 11.5±3.6 to 5.8±2.5 in cases versus 11.8±3.5 to 7.7±2.4 in controls (p<0.001). Individual symptoms, including hoarseness (p=0.04) and throat clearing (p=0.012), showed statistically significant improvements favoring the case group. Conclusions: Proton pump inhibitor therapy with rabeprazole, combined with lifestyle modifications and adjunctive medications, provides superior symptomatic and objective improvement in LPRD compared to lifestyle modifications alone, supporting inclusion of PPIs in first-line LPRD management protocols.

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