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Patient reported outcome measures are useful to characterize LPS, quantify symptom burden and monitor response, but are not specific for a diagnosis of LPRD. Patients presenting with both LPS and typical esophageal symptoms have higher pretest probability of LPRD, and time limited empiric acid suppressive agents and alginates may be appropriate. In contrast, upfront objective testing is recommended in isolated LPS prior to long\u2010term acid suppressive therapy. Laryngoscopy or stroboscopy can identify alternative etiologies of LPS. Esophagoscopy can demonstrate conclusive reflux evidence, but diagnostic yield is low. pH\u2010impedance monitoring, especially with hypopharyngeal sensors, assesses reflux mechanisms when investigating LPS, and can provide numbers of reflux episodes irrespective of acidity as well as proximal extent of these episodes. High\u2010resolution manometry does not provide a diagnosis of LPRD but serves to rule out motility disorders that mimic LPS. Prolonged wireless pH monitoring may be appropriate when typical esophageal reflux symptoms coexist. The evaluation of LPS requires a paradigm shift away from reflexive attribution to reflux and toward a structured diagnostic approach that systematically considers alternative etiologies of LPS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70351","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:42:36Z","timestamp":1779684156000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Laryngopharyngeal Symptoms and Laryngopharyngeal Reflux Disease: Diagnostic Testing and Clinical Approach Based on the San Diego Consensus"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1293-501X","authenticated-orcid":false,"given":"Ashli","family":"O'Rourke","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"Sweis","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University College London Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4705-1289","authenticated-orcid":false,"given":"Marie","family":"Jette","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Cates","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anais","family":"Rameau","sequence":"additional","affiliation":[{"name":"Sean Parker Institute for the Voice, Department of Otolaryngology\u2010Head and Neck Surgery Weill Cornell Medicine  New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Roman","sequence":"additional","affiliation":[{"name":"Digestive Physiology, Hospices Civils de Lyon, Hospital E Herriot, F\u201069437, LYON; Digestive Physiology, Lyon I University, F\u201069008, Lyon; LabTau Inserm Universit\u00e9 Lyon 1, Univ Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinglian","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, First Affiliated Hospital Sun Yat\u2010Sen University  Sun Yat\u2010Sen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6802-2121","authenticated-orcid":false,"given":"Frank","family":"Zerbib","sequence":"additional","affiliation":[{"name":"CHU de Bordeaux, Centre Medio\u2010Chirurgical Magellan, Hospital Haut\u2010Leveque, Department of Gastroenterology Universite de Bordeaux  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rena","family":"Yadlapati","sequence":"additional","affiliation":[{"name":"Center for Esophageal Diseases University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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