Effectiveness of Diet Recommendations for Laryngopharyngeal Reflux Disease: A Systematic Review for Clinical Practice and Studies.

Objective: To review the current literature dedicated to the effectiveness of the diet recommendations for laryngopharyngeal reflux disease (LPRD).

Methods: Two independent investigators conducted a PubMED, Scopus, and Cochrane Library database search for studies investigating the effectiveness of anti-reflux diet in LPRD patients. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements and the Methodological Index for Non-Randomized Studies (MINORS) tool were considered for study analyses.

Results: Ten studies (868 patients) were included: two prospective controlled, four prospective uncontrolled, and four retrospective series. Diet recommendations primarily included low-fat (n = 7), alcohol-free (n = 7), low-caffeine (n = 6), and alkaline (n = 6) foods. Studies demonstrated that diet adherence led to significant symptom reduction (54%-83.3%) in untreated patients, comparable to medication effectiveness. In patients with recalcitrant symptoms despite proton pump inhibitor therapy, specific diets (alkaline, low-fat, high-protein, or gluten-free) provided significant symptom relief. All studies combining diet with medication demonstrated better outcomes than medication alone. The overall quality of studies was low with a mean MINORS of 9.5 ± 2.2. No randomized controlled study has been conducted to compare diet versus medication.

Conclusion: Low-fat, high-protein, low-high-released sugar, and alkaline diet may appear as an effective single or combined treatment to medical therapy for patients with LPRD. Future controlled studies are needed to compare diet versus medication in LPRD populations, while considering mid- to long-term effects of diet.