Abstract
Laryngopharyngeal reflux (LPR) is characterized by the retrograde flow of gastric contents into the laryngopharyngeal region, causing inflammation and nonspecific symptoms such as chronic cough, throat irritation, and hoarseness. Proton pump inhibitors (PPIs) are commonly used for treatment. This study evaluates the efficacy of psyllium husk as an adjunct to PPI therapy in managing LPR. A prospective study involving 505 patients with confirmed LPR was conducted. Patients were randomized into three treatment groups: PPI monotherapy, PPI combined with prokinetics, and PPI combined with psyllium husk. Outcomes were assessed using the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and patient adherence rates over 16 weeks. Statistical analysis included ANOVA and chi-square tests. The PPI-psyllium husk group demonstrated the highest symptom resolution rate of 82%, significantly greater than the 75% achieved by the PPI-prokinetic group and 65% by the PPI monotherapy group (p < 0.001). This group also showed the greatest mean reduction in RSI scores (9.70 ± 1.50) and RFS scores (5.00 ± 0.95). Time to significant symptom improvement was shortest in the psyllium group (6.5 ± 1.2 weeks, p < 0.05). Improvements in individual symptoms such as chronic cough (51.55%) and heartburn (55.13%) were significantly higher compared to other groups. Adherence rates were highest in the psyllium group (85%, p < 0.01), likely due to better symptom control. Psyllium husk is a safe and effective adjunct to PPI therapy, offering superior symptom resolution, faster recovery, and enhanced mucosal healing. Its favourable safety profile and dual mechanism of action support its integration into LPR management strategies. Further research is needed to assess its long-term benefits and potential in personalized therapy.