Laryngopharyngeal reflux (LPR)
Treated with BID PPI x 3 months.
Positive Predictive Value of Laryngoscopy is low
Impedance > Laryngoscopy or empiric PPI therapy for diagnosis of LPR (ACG 2020)
Poor agreement on LPR findings
EGD findings not helpful
Impedance testing off meds in LPR is to document NO GERD
Ruling out GERD rules out LPR
Positive GERD during Impedance testing does NOT rule in LPR
Impedance testing while ON medication
Previous positive study
Large hiatal hernia
Esophagitis on EGD
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