Value of Barium Swallow Studies in Predicting the Response to Rabeprazole in Elderly Patients With Laryngopharyngeal Reflux Disease and Nonerosive Reflux Disease in Particular

Objectives: Laryngopharyngeal reflux disease (LPRD) is an important cause of throat discomfort in the elderly. Our objective was to investigate the usefulness of barium swallow studies for the diagnosis of LPRD. Methods: The subjects were 59 patients at least 60 years of age with LPRD suspected on laryngoscopic findings. We evaluated esophageal clearance using a barium swallow study and the upper gastrointestinal tract endoscopic findings of gastroesophageal reflux disease according to the revised Los Angeles classification, and correlated these findings with the effect of rabeprazole, a proton pump inhibitor. Results: Among subjects with positive reflux findings in the esophageal phase of the barium swallow, rabeprazole was significantly effective (p = 0.0025). To identify nonerosive reflux disease, we analyzed the 50 cases with a negative Los Angeles classification of upper gastrointestinal tract endoscopic findings. Rabeprazole was again significantly effective in patients with positive findings for esophageal reflux (p = 0.0025). Conclusions: Among elderly patients with suspected LPRD, there was a positive correlation between impaired esophageal clearance on the barium swallow study and the effectiveness of rabeprazole. The barium swallow study could be a screening test for LPRD in elderly patients with throat discomfort.