OBJECTIVE: To develop clinical tools assessing the refluxogenic potential of foods and beverages (F&B) consumed by patients with laryngopharyngeal reflux (LPR). METHODS: European experts of the LPR Study group of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological societies were invited to identify the components of Western European F&B that would be associated with the development of LPR. Based on the list generated by experts, four authors conducted a systematic review to identify the F&B involved in the development of esophageal sphincter and motility dysfunctions, both mechanisms involved in the development of gastroesophageal reflux disease and LPR. Regarding the F&B components and the characteristics identified as important in the development of reflux, experts developed three rational scores for the assessment of the refluxogenic potential of F&B, a dish, or the overall diet of the patient. RESULTS: Twenty-six European experts participated to the study and identified the following components of F&B as important in the development of LPR: pH; lipid, carbohydrate, protein composition; fiber composition of vegetables; alcohol degree; caffeine/theine composition; and high osmolality of beverage. A total of 72 relevant studies have contributed to identifying the Western European F&B that are highly susceptible to be involved in the development of reflux. The F&B characteristics were considered for developing a Refluxogenic Diet Score (REDS), allowing a categorization of F&B into five categories ranging from 1 (low refluxogenic F&B) to 5 (high refluxogenic F&B). From REDS, experts developed the Refluxogenic Score of a Dish (RESDI) and the Global Refluxogenic Diet Score (GRES), which allow the assessment of the refluxogenic potential of dish and the overall diet of the LPR patient, respectively. CONCLUSION: REDS, RESDI and GRES are proposed as objective scores for assessing the refluxogenic potential of F&B composing a dish or the overall diet of LPR patients. Future studies are needed to study the correlation between these scores and the development of LPR according to impedance-pH study.

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Avenue du Champ de mars 6 7000 Mons Belgium Department of Otorhinolaryngology and Head and Neck Surgery CHU de Bruxelles CHU Saint Pierre School of Medicine Université Libre de Bruxelles Brussels Belgium

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Mons Belgium

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Mons Belgium Department of Otorhinolaryngology and Head and Neck Surgery CHU de Bruxelles CHU Saint Pierre School of Medicine Université Libre de Bruxelles Brussels Belgium

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Biomedical and Clinical Sciences Phoniatric Unit L Sacco Hospital University of Milan Milan Italy

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Gastroenterology CHU de Bruxelles CHU Saint Pierre School of Medicine Université Libre de Bruxelles Brussels Belgium

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Gastrointestinal Surgery European School of Laparoscopic Surgery Saint Pierre University Hospital Université Libre de Bruxelles Brussels Belgium

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otolaryngology Head and Neck Surgery Thessaloniki Medical School Thessaloniki Greece

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otolaryngology Hospital Complex of Santiago de Compostela Santiago de Compostela Spain

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otolaryngology Pendik Training and Research Hospital Marmara University Istanbul Turkey

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otolaryngology Polyclinique Elsan Poitiers France

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otorhinolaryngology and Head and Neck Surgery CH Luxembourg Luxembourg Belgium

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otorhinolaryngology and Head and Neck Surgery CHU de Bruxelles CHU Saint Pierre School of Medicine Université Libre de Bruxelles Brussels Belgium

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otorhinolaryngology and Head and Neck Surgery CHU de Liège Liège Belgium

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otorhinolaryngology and Head and Neck Surgery CHU de Lille Université de Lille Lille France

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otorhinolaryngology and Head and Neck Surgery Foch Hospital Paris France

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otorhinolaryngology and Head and Neck Surgery University Hospital Ostrava Ostrava Czech Republic

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Department of Otorhinolaryngology Head and Neck Surgery Hospital Universitario Donostia San Sebastian Spain

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Division of Ear Nose and Throat Diseases Ellenbogen Malmö Sweden

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Division of Otolaryngology Head and Neck Surgery Centre Hospitalier de l'Université de Montréal Montreal QC Canada

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France Division of Phoniatrics and Audiology Department of Mental and Physical Health and Preventive Medicine University of L Vanvitelli Naples Italy

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France ENT Audiology and Phoniatric Unit University of Pisa Pisa Italy

Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto Rhino Laryngological Societies Paris France World Hearing Center Institute of Physiology and Pathology of Hearing Kajetany Warsaw Poland

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