OBJECTIVE: To propose a European consensus for managing and treating laryngopharyngeal reflux disease (LPRD) to guide primary care and specialist physicians. METHODS: Twenty-three European experts (otolaryngologists, gastroenterologists, surgeons) participated in a modified Delphi process to revise 38 statements about the definition, clinical management, and treatment of LPRD. Three voting rounds were conducted on a 5-point scale and a consensus was defined a priori as agreement by 80% of the experts. RESULTS: After the third round, 36 statements composed the first European Consensus Report on the definition, diagnosis, and treatment of LPRD. The hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring is the gold standard for diagnosing LPRD (> 1 pharyngeal reflux event) and treating the LPRD with personalized therapy. The empirical treatment needs to be based on diet, stress reduction, and alginates or antiacids to address the acidic and alkaline reflux events. Proton pump inhibitors are kept for patients with acidic LPRD and gastroesophageal reflux disease (GERD) findings. The treatment needs to be as short as possible (minimum two months). The medication can be progressively reduced for patients with relief of symptoms. Changing medication class can be considered for refractory LPRD rather than an increase in drug doses. CONCLUSION: A consensus endorsed by the Confederation of European Otorhinolaryngology-Head and Neck Surgery Societies is presented to improve the management and treatment of LPRD. The approved statements could improve collaborative research through the adoption of common management approaches to LPRD.

Department of Biomedical and Clinical Sciences ASST Fatebenefratelli Sacco UO Otorhinolaryngology Luigi Sacco Hospital Università degli Studi di Milano Milan Italy

Department of ENT International Voice Center Austria Salzburg University Salzburg Austria

Department of Gastroenterology CHU Saint Pierre Brussels Belgium

Department of Otolaryngology Academy of Medicine Lithuanian University of Health Sciences Kaunas Lithuania

Department of Otolaryngology and Phoniatrics Head and Neck Surgery Helsinki University Hospital and University of Helsinki Helsinki Finland

Department of Otolaryngology Head and Neck Surgery Comenius University University Hospital Bratislava Slovakia

Department of Otolaryngology Head Neck Surgery UFR Simone Veil Phonetics and Phonology Laboratory Paris France

Department of Otorhinolaryngology and Cervicofacial Surgery University Medical Centre Ljubljana Slovenia

Department of Otorhinolaryngology and Head and Neck Surgery CHU Saint Pierre Brussels Belgium

Department of Otorhinolaryngology and Head and Neck Surgery Thessaloniki Medical School Thessaloniki Greece

Department of Otorhinolaryngology and Head and Neck Surgery University Hospital Ostrava and Faculty of Medicine University of Ostrava Ostrava Czechia

Department of Otorhinolaryngology Head and Neck Surgery Center Hospitalier de Luxembourg Eich Luxembourg

Department of Otorhinolaryngology Head and Neck Surgery Hospital Universitario Donostia San Sebastian Spain

Department of Surgery Division of Laryngology and Broncho esophagology Department of Otolaryngology Head and Neck Surgery EpiCURA hospital University of Mons Mons Belgium

Department of Surgery Oncology and Gastroenterology University Hospital of Padua Padua Italy

Department of Surgery Paracelsus Medical University Salzburg Austria

Division of Phoniatrics and Audiology Department of Mental and Physical Health and Preventive Medicine University of Campania Luigi Vanvitelli Naples Italy

Division of Phoniatrics and Speech Pathology Department of Otorhinolaryngology Head and Neck Surgery University Hospital Zurich University of Zurich Zurich Switzerland

ENT Audiology and Phoniatric Unit University of Pisa Pisa Italy

Faculty of Health Sciences University of Klaipėda Klaipėda Lithuania

Faculty of Medicine and Surgery University of Enna Kore Enna Italy

Faculty of Medicine Lokman Hekim University Ankara Türkiye

Fonomer Phoniatrics and Audiology Clinic Ankara Türkiye

FortMedica ENT Private Practice Prague Czech Republic

Head Neck and Oral Surgery Unit Department of Head Neck Surgery Otolaryngology Morgagni Pierantoni Hospital 47121 Forlì Italy

Maxillofacial Surgery Unit Department of Medicine Surgery and Pharmacy University of Sassari 07100 Sassari Italy

Minimally Invasive General and Oncologic Surgery Center Humanitas Gavazzeni University Hospital Bergamo Italy

Organi di Senso Department Sapienza University of Rome Viale del Policlinico 151 00161 Rome Italy

Otolaryngology Unit Department of Health Sciences Santi Paolo e Carlo Hospital Università degli Studi di Milano 20121 Milan Italy

Otorhinolaryngology Head and Neck Surgery Department Complexo Hospitalario Universitario A Coruña A Coruña Galicia Spain

Research Committee of Young Otolaryngologists of the International Federations of Oto rhino laryngological Societies Paris France

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