Effectiveness of Diet and Lifestyle Changes for the Treatment of Laryngopharyngeal Reflux Disease: A Prospective Study

Jérôme R Lechien

doi:10.1016/j.jvoice.2025.09.002

Effectiveness of Diet and Lifestyle Changes for the Treatment of Laryngopharyngeal Reflux Disease: A Prospective Study

J Voice. 2025 Sep 18:S0892-1997(25)00367-4. doi: 10.1016/j.jvoice.2025.09.002. Online ahead of print.

Author

Jérôme R Lechien¹

Affiliation

¹ Department of Surgery, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otolaryngology - Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France; Department of Otolaryngology, Polyclinic of Poitiers, Elsan Hospital, Poitiers, France; Department of Otolaryngology-Head & Neck Surgery, CHU Saint-Pierre (CHU de Bruxelles), Brussels, Belgium. Electronic address: Jerome.Lechien@umons.ac.be.

PMID: 40973508
DOI: 10.1016/j.jvoice.2025.09.002

Abstract

Objective: To investigate the effectiveness of diet and lifestyle changes as a single treatment for laryngopharyngeal reflux disease (LPRD).

Methods: Forty-eight patients with LPRD confirmed by 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring (HEMII-pH) were prospectively recruited from two European hospitals between January 2022 and January 2025. Patients were treated with a standardized anti-reflux diet for 3 months. Reflux symptom score (RSS) and reflux sign assessment (RSA) were used to evaluate prediet to postdiet changes in symptoms and findings.

Results: Forty-four patients completed the 3-month diet and lifestyle recommendations (mean age 50.2 ± 16.5; 63.6% female). There were 14 (52.3%) mild, 8 (18.2%) moderate, and 13 (29.5%) severe LPRD according to IFOS classification. Most pharyngeal reflux events were non-acid. After dietary and lifestyle modifications, significant improvements occurred in otolaryngological, digestive, and respiratory symptom (items and RSS) scores. Symptom relief occurred in 88.6% of cases, with complete symptom resolution in 40.9% of patients. Laryngeal signs and RSA scores significantly decreased. Nine patients (20.5%) required additional medication despite adherence to recommendations. No baseline predictors of response were identified.

Conclusion: A low-fat, high-protein, and low-high-release sugar diet combined with lifestyle changes may be an effective single treatment for LPRD. Future controlled studies are needed to compare diet versus medication in LPRD populations, with consideration of mid- to long-term effects of diet on general health.

Keywords: Diet; Gastroesophageal reflux; Head neck surgery; Laryngopharyngeal reflux; Otolaryngology.

Publication types

Case Reports