Lifestyle program linked to greater symptom relief than medications for laryngopharyngeal reflux

Clinical takeaway: For patients with laryngopharyngeal reflux disease, emphasize adherence to a low-fat, low–quick-release sugar, high-protein diet and stress-reduction strategies alongside other lifestyle measures. This study suggests a structured lifestyle program may be at least as effective as, and possibly more effective than, commonly prescribed medications for symptom improvement.

Laryngopharyngeal reflux disease (LPRD) is a common cause of chronic throat symptoms, including hoarseness, throat clearing, chronic cough, and globus sensation. Although proton pump inhibitors and other pharmacologic therapies are frequently prescribed, comparative evidence for the major treatment approaches has been limited.

In this multicenter cohort study of 145 adults with objectively confirmed LPRD, all treatment strategies—including proton pump inhibitors, alginates, antacids, and a strict antireflux diet combined with stress-reduction activities—improved reflux symptoms and laryngeal findings after three months.

Patients in the diet and stress-reduction group reported lower posttreatment reflux symptom scores than those treated with antacids. The lifestyle group also had the highest treatment response rate at 81.2%, compared with 56.3% for proton pump inhibitors, 57.9% for alginates, and 74.1% for antacids. Response rates were approximately 25 percentage points higher with the lifestyle program than with proton pump inhibitors and 23 percentage points higher than with alginates.

Although the lifestyle group had lower posttreatment symptom scores than the antacid group, the magnitude of symptom improvement from baseline was similar across treatment groups, and laryngeal examination findings improved to a similar extent.

“Adherence to an antireflux diet and stress-reduction activities may be associated with comparable or greater symptom relief at 3 months posttreatment compared with conventional medical therapies. Randomized clinical trials comparing the 4 regimens are needed,” the study authors concluded.

Source: Lechien JR, et al. (2026 July 2) JAMA Otolaryngol Head Neck Surg. Comparison of Diet and Lifestyle Program With 3 Medication Approaches for Laryngopharyngeal Reflux Disease Management