Validity of Reflux Symptom Index in the Diagnosis of Laryngopharyngeal Reflux Disease

Abstract Introduction: Laryngopharyngeal reflux (LPR) is a disease, in which the diagnosis and treatment are controversial. The main objectives of this study were to assess the validity of the reflux symptom index (RSI) in patients exhibiting symptoms of LPR disease (LPRD) or gastroesophageal reflux disease (GERD). Materials and Methods: This study was a hospital-based, cross-sectional study. The study included all patients above the age of 12 years who presented to the ENT outpatient department with symptoms of LPRD or GERD. Patients who refused to give consent for the study, those who had undergone medical treatment past 6 weeks or surgical treatment for similar complaints, patients with malignancy of the hypopharynx and esophagus, patients with neurological causes of dysphonia and dysphagia, patients with a history of throat trauma or prior intubation, patients with allergies or chronic upper respiratory tract infections, and pregnant patients were excluded from the study. The variables examined in this study included age, sex, RSI, and reflux finding score. Results: The majority of patients (49.3%) with LPRD were in the age group of 31–50 years. Among the patients diagnosed with LPRD were females, only 15 patients (21.7%) diagnosed with LPRD had diabetes mellitus, only 7 patients (10.1%) had bronchial asthma, 4 patients (5.8%) diagnosed with LPRD had a history of thyroid disease, 8.7% had a history of smoking/tobacco usage addiction, and 18.8% of the patients experienced recurrent throat infection. The sensitivity was found to be 97.1%, specificity 66.7%, positive predictive value 84.8%, and negative predictive value 92.3%. The diagnostic accuracy of RSI was calculated to be 86.7%. It was found that only 46 of the 69 LPRD-positive patients (66.7%) showed symptoms suggestive of GERD. Conclusion: LPRD is predominantly a lifestyle-related disease. The fast-food lifestyle and the irregular and unhealthy spicy high acid dietary habits have led to a rapid increase in the prevalence of gastroesophageal reflux, and hence, the LPR in the general population, especially India.