Effectiveness of zinc supplementation in laryngopharyngeal reflux assessed by reflux symptom index and reflux finding score

Abstract

Background and aim: Standard therapy for Laryngopharyngeal Reflux (LPR) with Proton Pump Inhibitors (PPIs) frequently yields suboptimal responses, particularly in reversing laryngeal mucosal injury. This study aimed to evaluate the clinical effectiveness of adjunctive zinc supplementation in patients receiving PPI therapy. Methods: An experimental pre–post control group study was conducted involving 22 patients diagnosed with LPR (Reflux Symptom Index [RSI] ≥13 and Reflux Finding Score [RFS] ≥7). Participants were allocated into two groups. The treatment group received Omeprazole 20 mg twice daily plus Zinc Sulfate 20 mg once daily, while the control group received Omeprazole 20 mg twice daily plus placebo for 12 weeks. Treatment effectiveness was assessed using changes in RSI and RFS scores. Statistical analyses were performed using the Mann–Whitney U test and Wilcoxon signed-rank test, with p < 0.05 considered statistically significant. Results: Both groups demonstrated post-treatment improvement. However, the zinc group exhibited significantly greater reductions in clinical scores. The mean reduction (Δ) in RSI score in the zinc group was 7.46 ± 1.7 compared with 2.91 ± 2.9 in the control group (p = 0.003). The mean reduction in RFS score was 3.72 ± 1.7 in the zinc group versus 0.73 ± 1.5 in controls (p = 0.001). Laryngeal edema resolution was more consistently observed in the zinc group. Conclusions: Combination of PPI and zinc supplementation is superior to PPI monotherapy in improving both subjective symptoms and objective laryngoscopic findings in LPR patients. Zinc appears to be an effective adjuvant therapy that accelerates mucosal inflammatory resolution.

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