According to the Montreal Consensus Conference, some critical issues have been highlighted, as follows:

In addition, some studies support the notion that GERD, as well as smoking and alcohol use, are risk factors for laryngeal cancer. In particular, there is a large number of data on the growing prevalence of laryngopharyngeal symptoms in up to 60% of GERD patients. Laryngopharyngeal symptoms are increasingly recognized by general physicians, lung specialists and ear, nose and throat (ENT) surgeons. LPR may be manifested as laryngeal symptoms such as cough, sore throat, hoarseness, dysphonia and globus, as well as signs of laryngeal irritation at laryngoscopy. According to the Montreal Consensus Conference, the manifestations of gastroesophageal reflux disease (GERD) have been classified into either esophageal or extraesophageal syndromes and, among the latter ones, the existence of an association between LPR and GERD has been established. Laryngopharyngeal reflux (LPR) is defined as the reflux of gastric content into the larynx and pharynx. The present review is aimed at critically discussing the current treatment options in patients with laryngopharyngeal reflux, and provides a perspective on the development of new therapies. Overall, there are scant conflicting results to assess the effect of reflux treatments (including dietary and lifestyle modification, medical treatment, antireflux surgery) on laryngopharyngeal reflux. Although it is a pragmatic clinical strategy to start with empiric trials of proton pump inhibitors, many patients with suspected laryngopharyngeal reflux have persistent symptoms despite maximal acid suppression therapy. Current critical issues in diagnosing laryngopharyngeal reflux are many nonspecific laryngeal symptoms and signs, and poor sensitivity and specificity of all currently available diagnostic tests.

However, laryngopharyngeal reflux is a multifactorial syndrome and gastroesophageal reflux disease is not the only cause involved in its pathogenesis. A large number of data suggest the growing prevalence of laryngopharyngeal symptoms in patients with gastroesophageal reflux disease. Laryngopharyngeal reflux is defined as the reflux of gastric content into larynx and pharynx.

Relux 2005