It's common for doctors to prescribe proton pump inhibitors (PPIs) to patients who complain of persistent throat symptoms. New research, however, advises these pills not be prescribed for throat symptoms because they were found to have no benefit over placebos.
Persistent throat symptoms, which may include chronic throat clearing, coughing, hoarseness, or sensations of a lump in the throat, are treated with PPIs because these symptoms are thought to be from acid reflux. More specifically, they're thought to be caused by stomach acid backflowing into the pharynx and larynx in what's known as laryngopharyngeal reflux.
Funded by the National Institute for Health and Care Research Health Technology Assessment program in the UK, this research studied 346 adults treated at UK hospitals for these unexplained throat symptoms lasting more than 6 weeks.
One group of study participants took two pills of the PPI lansoprazole for 16 weeks. Another group took a placebo. Participants reported symptoms and quality of life through ongoing questionnaires. Both groups reported similar symptom improvement with no clear benefit in the treatment group. Findings between the two groups were also similar regardless of age, sex, weight, symptom severity, use of cigarettes or use of alcohol.
Both groups also reported similar side effects of headache, diarrhea and feeling unwell, but the single severe side effect of a rash occurred only in the treatment group.
In the short run, PPI side effects tend to be mild, such as headache and feeling sick. The longer they're taken, however, the more serious potential side effects can become, such as an increased risk of bone fractures.
This study suggests that widespread PPI prescriptions for persistent, unexplained throat symptoms isn't appropriate. These same researchers are planning to test the effectiveness of other antacid drugs, like over-the-counter Gaviscon prepared from seaweed. Other therapies that alter behavior may be beneficial but need more investigation as well.