Eight weeks of omeprazole 20 mg significantly reduces both laryngopharyngeal reflux and comorbid chronic rhinosinusitis signs and symptoms: randomized, double blind, placebo controlled trial

Abstract

Objectives

Gastroesophageal reflux recommended treatment (dose and duration) with proton pump inhibitor (PPI) compared to placebo significantly reduces the signs and symptoms of laryngopharyngeal reflux (LPR) and comorbid chronic rhinosinusitis (CRS).

Design

Double blind randomized placebo controlled trial.

Setting

Eight weeks of treatment with omeprazole 20 mg once daily (OD).

Participants

60 patients (28 women, aged 19-87 years) with diagnosed LPR and comorbid CRS.

Main outcome measures

Significant reduction of signs and symptoms (reflux symptom index (RSI) score as subjective, and reflux finding score (RFS) as objective measure) of LPR after 8 weeks of treatment with omeprazole 20 mg OD when compared to placebo. Secondary objectives were significant reduction of signs and symptoms of comorbid CRS after 8 weeks of treatment with omeprazole 20 mg OD when compared to placebo; and the association of the severity of signs and symptoms of LPR with the ones of CRS.

Results

RSI and RFS decreased significantly more in the active treatment group after 8 weeks compared to placebo (p<0.001 for both). CRS and endoscopy scoring decreased both significantly more in the active group after 8 weeks compared to placebo (p<0.001 for both). CRS scoring significantly correlated with RSI (R=0.312, p=0.015) but not with RFS (R=0.199, p=0.127).

Conclusions

The results of our trial suggest that omeprazole 20 mg OD for 8 weeks was effective in reducing signs and symptoms of both LPR and CRS, although in most patients still present at the end of the trial.

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