Knowledge, Diagnostic Approaches, and Management Patterns of Laryngopharyngeal Reflux among Primary Care Physicians and Otolaryngologists: A Cross-Sectional Study”
DOI:
https://doi.org/10.37375/susj.v16i1.4101Keywords:
Laryngopharyngeal reflux, physician knowledge, diagnosis, management, primary care, otolaryngologyAbstract
Background: Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of gastroesophageal reflux disease (GERD) that often presents with nonspecific symptoms, posing challenges in diagnosis and management. Variability in physician knowledge, diagnostic approaches, and treatment strategies may adversely affect patient outcomes. This study aimed to assess and compare the knowledge, diagnostic practices, and management patterns of LPR among primary care physicians and otolaryngologists.
Methods: A cross-sectional survey was conducted among 197 physicians, including primary care physicians and otolaryngologists. A structured questionnaire was used to evaluate knowledge of LPR pathophysiology, symptom recognition, differentiation from GERD, diagnostic approaches, and management strategies, including pharmacologic treatment, lifestyle modification, dietary counseling, and referral practices. Data were analyzed using descriptive statistics and presented as frequencies and percentages, stratified by specialty.
Results: Overall, 58% of participants demonstrated adequate knowledge of LPR, with significantly higher levels among otolaryngologists compared to primary care physicians (72% vs. 44%). Recognition of LPR as an extraesophageal condition was reported by 72% of respondents (90% vs. 54%), awareness of “silent reflux” by 65% (80% vs. 50%), and correct differentiation from GERD by 60% (76% vs. 44%).
Diagnostic approaches differed substantially between groups. Primary care physicians predominantly relied on symptom-based assessment (80%) and empirical proton pump inhibitor (PPI) trials (76%), whereas otolaryngologists more frequently utilized laryngoscopy (80%) and standardized diagnostic tools (36%). Referral rates were also higher among otolaryngologists (50% vs. 24%).
In terms of management, PPIs were the most commonly prescribed therapy (84% among primary care physicians vs. 90% among otolaryngologists). However, otolaryngologists were more likely to recommend lifestyle modifications (64% vs. 36%), dietary counseling (56% vs. 30%), combination therapy (50% vs. 20%), and referral for further evaluation (40% vs. 16%).
Conclusion: Significant variability exists in physicians’ knowledge, diagnostic approaches, and management of LPR. Otolaryngologists demonstrate more comprehensive and guideline-oriented practices, whereas primary care physicians rely more heavily on empirical pharmacologic therapy. Targeted educational interventions, implementation of standardized diagnostic tools, and greater emphasis on lifestyle and dietary modifications are recommended to improve early diagnosis and optimize patient outcomes.
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