Proton-Pump Inhibitor Therapy for Postnasal Drainage?

Lansoprazole outperformed placebo, reviving old questions about silent gastroesophageal reflux disease and extraesophageal reflux.

Can a proton-pump inhibitor (PPI) improve postnasal drainage (PND) symptoms? To find out, researchers randomized 75 nonsmokers who had poorly controlled chronic PND but no evidence of sinusitis or allergies to receive lansoprazole (30 mg twice daily) or placebo. About one third of participants had previously used a PPI. The drug manufacturer funded the study.

All patients had either a negative radioallergosorbent test (RAST) allergy panel (or skin test) or a positive RAST result but an insufficient response to conventional therapies such as allergy-desensitization shots, topical nasal corticosteroids, or antihistamines. Lack of sinusitis was documented by computed tomography scan. Ambulatory pH and impedance monitoring (performed in 65% of p…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors