The San Diego Consensus For Laryngopharyngeal Symptoms and Laryngopharyngeal Reflux Disease.

Details

• Alternative Title:
  The American Journal of Gastroenterology, 2026, v. 121, no. 2: The San Diego Consensus For Laryngopharyngeal Symptoms and Laryngopharyngeal Reflux Disease.
• Journal Article:
  The American Journal of Gastroenterology
• Personal Author:
  Yadlapati, Rena ; Weissbrod, Philip ; Walsh, Erin ; Carroll, Thomas L. ; Chan, Walter W ; Gartner-Schmidt, Jackie ; Guadagnoli, Livia ; Jette, Marie ; Myers, Jennifer C ; O'Rourke, Ashli ; Sweis, Rami ; Wu, Justin ; Barkmeier-Kraemer, Julie M ; Cates, Daniel ; Chen, Chien-Lin ; Coss-Adame, Enrique ; Dion, Gregory ; Francis, David ; Kaneko, Mami ; Lechien, Jerome R. ; Misono, Stephanie ; Rameau, Anais ; Roman, Sabine ; Vertigan, Anne ; Xiao, Yinglian ; Zerbib, Frank ; Greytak, Madeline ; Pandolfino, John E. ; Gyawali, C Prakash
• Description:
  The term laryngopharyngeal reflux (LPR) is frequently applied to aerodigestive symptoms despite lack of objective reflux evidence. The aim of this initiative was to develop a modern care paradigm for LPR supported by otolaryngology and gastroenterology disciplines.
  
  A 28-member international interdisciplinary working group developed practical statements within the following domains: definition/terminology, initial diagnostic evaluation, reflux monitoring, therapeutic trials, behavioral factors and therapy, and risk stratification. Literature reviews guided statement development and were presented at virtual/in-person meetings. Each statement underwent 2 or more rounds of voting per the RAND Appropriateness Method; statements reaching appropriateness with ≥80% agreement are included as recommendations.
  
  The term laryngopharyngeal symptoms (LPS) applies to aerodigestive symptoms with potential to be induced by reflux and include cough, voice change, throat clearing, excess throat phlegm, and throat pain. Laryngopharyngeal reflux disease (LPRD) refers to patients with LPS and objective evidence of reflux. Importantly, the presence of LPS does not equate to LPRD. Laryngoscopy has value in assessing for nonreflux laryngopharyngeal processes, but laryngoscopic findings alone cannot diagnose LPRD. LPS patients should be categorized as with or without concurrent esophageal reflux symptoms. While lifestyle modification and empiric trials of acid suppression ± alginates are appropriate when esophageal reflux symptoms coexist, upper endoscopy and ambulatory reflux monitoring are required for LPRD diagnosis when symptoms persist, when LPS is isolated, or when management needs to be escalated to include invasive antireflux management. The two recommended ambulatory reflux monitoring modalities, 24-hour pH-impedance and 96-hour wireless pH monitoring, are not mutually exclusive with distinct roles for the evaluation of LPS. Laryngeal hyperresponsiveness and hypervigilance commonly contribute to both LPS and LPRD presentations and are responsive to laryngeal recalibration therapy and neuromodulators.
  
  The San Diego Consensus represents the formal modern-day interdisciplinary care paradigm to evaluate and manage LPS and LPRD.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Laryngopharyngeal Reflux
  • Laryngoscopy
  • Proton Pump Inhibitors
  • Esophageal pH Monitoring
  • Cough
  • Pharyngitis
• Source:
  The American Journal of Gastroenterology, 2026, v. 121, no. 2
• DOI:
  https://doi.org/10.14309/ajg.0000000000003482
• ISSN:
  0002-9270 ; 1572-0241
• Pubmed ID:
  40197644
• Pubmed Central ID:
  PMC12353988
• Document Type:
  Text
• Funding:
  K23 DK125266/DK/NIDDK NIH HHSUnited States/ ; R01 DK092217/DK/NIDDK NIH HHSUnited States/ ; R01 DK139089/DK/NIDDK NIH HHSUnited States/ ; R34HL174877/HL/NHLBI NIH HHSUnited States/ ; OT2 OD032720/OD/NIH HHSUnited States/ ; K76 AG079040/AG/NIA NIH HHSUnited States/ ; OT2 OD032720/CD/ODCDC CDC HHSUnited States/ ; R03 DK135513/DK/NIDDK NIH HHSUnited States/ ; R34 HL174877/HL/NHLBI NIH HHSUnited States/ ; K23 DK125266/DK/NIDDK NIH HHSUnited States/ ; R03 DK135513/DK/NIDDK NIH HHSUnited States/ ; R01 DK139089/DK/NIDDK NIH HHSUnited States/ ; K76 AG079040/AG/NIA NIH HHSUnited States/ ; OT2 OD032720/CD/ODCDC CDC HHSUnited States/ ; R34HL174877/HL/NHLBI NIH HHSUnited States/ ; R01 DK092217/DK/NIDDK NIH HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  322-336 (31 pdf pages)
• Volume:
  121
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/261502/cdc_261502_DS1.pdf
• File Type:
  [PDF - 826.47 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:01014d7ebd8de4f64b4e27fbd19dd2b3419a220cd45550ef2a52f357b46c52dd08540222575e2c60c313b79b61e88eadce74f61b11d52fd1b145afe821a32aac