{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:52:08Z","timestamp":1785775928981,"version":"3.56.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T00:00:00Z","timestamp":1590364800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Laryngopharyngeal reflux (LPR) and associated symptoms can be refractory to treatment with acid suppressing medication. We investigated the role and evidence for complementary and alternative medicine (CAM) for LPR in this systematic review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods:<\/jats:title>\n                    <jats:p>Complementary and alternative treatment was defined in this systematic review as any non-acid suppressing medication, treatment, or therapy. A literature search was performed by two authors in consultation with a medical librarian using controlled vocabulary for \u201ccomplementary and alternative medicine\u201d and \u201claryngopharyngeal reflux\u201d in the databases PubMed and EMBASE, with supplemental searches with Google Scholar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty articles were included in this review for the modalities: alginate, diet modification, prokinetics, respiratory retraining, voice therapy, rikkunshito (RKT), hypnotherapy, and sleep positioning. The studies were analyzed for bias based on the Cochrane criteria for RCTs and Methodological Index for non-RCT (MINORS) criteria for all other studies. For each modality a level of evidence was assigned to the current body of evidence using the GRADE approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is mixed evidence with a high degree of bias and heterogeneity between studies for the modalities presented in the paper. Based on this review, an anti-reflux diet is recommended for all patients and there is some low-quality evidence to support alkaline water. For patients with predominant vocal symptoms there is evidence that supports voice therapy. There is insufficient evidence to recommend prokinetics at this time. For patients with predominant globus symptoms, alginate, RKT, and relaxation strategies may be used in conjunction with acid suppressing medications for symptom relief.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0003489420922870","type":"journal-article","created":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T08:10:36Z","timestamp":1590394236000},"page":"1030-1039","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Alternatives to Acid Suppression Treatment for Laryngopharyngeal Reflux"],"prefix":"10.1177","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5446-0449","authenticated-orcid":false,"given":"Mikayla J.","family":"Huestis","sequence":"first","affiliation":[{"name":"Boston University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7247-0261","authenticated-orcid":false,"given":"Katherine R.","family":"Keefe","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0098-8533","authenticated-orcid":false,"given":"Chase I.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren F.","family":"Tracy","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine, Boston, MA, USA"},{"name":"Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica R.","family":"Levi","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine, Boston, MA, USA"},{"name":"Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,5,25]]},"reference":[{"key":"bibr1-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819827488"},{"key":"bibr2-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27591"},{"key":"bibr3-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-016-4142-y"},{"key":"bibr4-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26806"},{"key":"bibr5-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13737"},{"key":"bibr6-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13716"},{"key":"bibr7-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-009-1098-1"},{"issue":"2","key":"bibr8-0003489420922870","first-page":"116","volume":"16","author":"Patrick L.","year":"2011","journal-title":"Altern Med Rev"},{"key":"bibr9-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-018-0641-x"},{"key":"bibr10-0003489420922870","unstructured":"Higgins J, Green S (ed.). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, 2011. Available on www.handbook.cochrane.org."},{"key":"bibr11-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.02748.x"},{"key":"bibr12-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-008-0708-7"},{"issue":"2","key":"bibr13-0003489420922870","first-page":"1","volume":"2","author":"Pedersen M.","year":"2012","journal-title":"Otolaryngology"},{"key":"bibr14-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27111"},{"key":"bibr15-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-5079-0"},{"key":"bibr16-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1177\/000348941112000501"},{"key":"bibr17-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.1454"},{"key":"bibr18-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2017.10.014"},{"issue":"1","key":"bibr19-0003489420922870","first-page":"73","volume":"95","author":"Hunchaisri N.","year":"2012","journal-title":"J Med Assoc Thail"},{"key":"bibr20-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2341-8"},{"key":"bibr21-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200408000-00005"},{"key":"bibr22-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1177\/000348940611501007"},{"key":"bibr23-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20985"},{"key":"bibr24-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215113000832"},{"key":"bibr25-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2009.00992.x"},{"key":"bibr26-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.08.025"},{"key":"bibr27-0003489420922870","doi-asserted-by":"publisher","DOI":"10.2152\/jmi.63.227"},{"key":"bibr28-0003489420922870","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i31.5118"},{"key":"bibr29-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2010.01064.x"},{"issue":"5","key":"bibr30-0003489420922870","first-page":"603","volume":"38","author":"Tierney WS","year":"2017","journal-title":"Am J Otolaryngol - Head Neck Med Surg"},{"key":"bibr31-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(02)00097-8"},{"key":"bibr32-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200108000-00001"},{"key":"bibr33-0003489420922870","unstructured":"Gaviscon\u00ae Tablets - Heartburn; Acid Reflux Relief | Gaviscon. https:\/\/www.gaviscon.com\/products\/tablets\/. Accessed August 2, 2019."},{"issue":"5","key":"bibr34-0003489420922870","first-page":"297","volume":"9","author":"Jarosz M","year":"2014","journal-title":"Prz Gastroenterol"},{"key":"bibr35-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13269"},{"key":"bibr36-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1590\/S2179-64912012000100014"},{"key":"bibr37-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811422014"},{"key":"bibr38-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-013-0788-z"},{"key":"bibr39-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-007-1986-7"},{"key":"bibr40-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.2000.279.2.G262"},{"key":"bibr41-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/dow020"},{"key":"bibr42-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1177\/000348941212100702"},{"key":"bibr43-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24738"},{"key":"bibr44-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31802d83cf"},{"key":"bibr45-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2017.03.015"},{"key":"bibr46-0003489420922870","first-page":"274","author":"Lechien JR","year":"2017","journal-title":"Eur Arch OtorhinolLaryngology"},{"key":"bibr47-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-011-0488-5"},{"key":"bibr48-0003489420922870","first-page":"1","volume":"2015","author":"Zhang Y","year":"2015","journal-title":"Evidence-Based Complement Altern Med"},{"key":"bibr49-0003489420922870","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.37071"}],"container-title":["Annals of Otology, Rhinology &amp; Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0003489420922870","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0003489420922870","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0003489420922870","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:33:26Z","timestamp":1777376006000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0003489420922870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,25]]},"references-count":49,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1177\/0003489420922870"],"URL":"https:\/\/doi.org\/10.1177\/0003489420922870","relation":{},"ISSN":["0003-4894","1943-572X"],"issn-type":[{"value":"0003-4894","type":"print"},{"value":"1943-572X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,25]]}}}