Document Type
Article
Publication Date
8-20-2026
Abstract
Laryngopharyngeal reflux (LPR) is a highly prevalent condition in otolaryngology practice, characterized by reflux of gastric contents into the pharynx and larynx. Although proton pump inhibitors (PPIs) remain first-line therapy, many patients report persistent symptoms. In refractory cases, histamine-2 receptor antagonists (H2RAs) are often employed as adjunctive or standalone therapy due to their rapid onset and accessibility. However, their utility as daily therapy is limited by tachyphylaxis, with significant loss of acid suppression within days of continuous use. Despite longstanding evidence from gastroenterology literature discouraging daily H2RA therapy, these agents remain frequently prescribed in otolaryngology practice. Contemporary ear, nose, and throat (ENT)-specific guidance on their role in LPR is lacking. In patients with ongoing laryngopharyngeal symptoms despite optimized PPI therapy, a systematic, phenotype-driven approach is recommended, incorporating objective testing with hypopharyngeal-esophageal pH-impedance monitoring, alternative agents including alginates, and consideration of surgical or endoscopic interventions. Greater adherence to evidence-based recommendations may improve outcomes.
Recommended Citation
Linguiti, Sophia; Palmer, W. Jack; Shukla, Janvi J.; Tibbetts, Kathleen; Huntley, Colin; and Spiegel, Joseph, "Should H2-Blockers Be Used for the Treatment of Laryngopharyngeal Reflux?" (2026). Department of Otolaryngology - Head and Neck Surgery Faculty Papers. Paper 120.
https://jdc.jefferson.edu/otofp/120
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
42626405
Language
English
Comments
This article is the author’s final published version in OTO Open, Volume 10, Issue 3, 2026, Article number e70278.
The published version is available at https://doi.org/10.1002/oto2.70278. Copyright © 2026 The Author(s).