Treatment with alkaline water and a plant-based, Mediterranean-style diet may be as effective as standard proton pump inhibitor (PPI) therapy for reducing reflux symptoms in patients with laryngopharyngeal reflux (LPR). Findings from this study were published in JAMA Otolaryngology-Head & Neck Surgery.

In this retrospective study, researchers from New York Medical College, Valhalla, NY, compared the efficacy of diet-based treatment consisting of alkaline water (pH >8.0) and plant-based Mediterranean-style diet vs. the conventional PPI approach. The primary outcome was based on the change in the Reflux Symptom Index (RSI) between the LPR patients treated with PPI and standard reflux precautions (n=85) and patients treated with alkaline water, 90% plant-based, Mediterranean-style diet, and standard reflux precautions (n=99). 

Related Articles

The data showed 54.1% of patients in the PPI group achieved a clinically meaningful (≥6 points) reduction in RSI vs. 62.6% in the diet-based group (difference 8.05, 95% CI: –5.74 to 22.76). The PPI group demonstrated a mean RSI reduction of 27.2% vs. 39.8% in the diet-based group (difference 12.10, 95% CI: 1.53 to 22.68). 

These findings suggest that the effect of PPI on achieving a significant RSI reduction was not significantly better than that of alkaline water, plant-based Mediterranean-style diet with standard reflux precautions “although the difference in the two treatments could be clinically meaningful in favor of the dietary approach,” added study author Craig H. Zalvan, MD. The dietary approach resulted in a significantly greater RSI percent reduction vs. the PPI approach. 

“Because the relationship between percent change and response to treatment has not been studied, the clinical significance of this difference requires further study. Nevertheless, this study suggests that a plant-based diet and alkaline water should be considered in the treatment of LPR. This approach may effectively improve symptoms and could avoid the costs and adverse effects of pharmacological intervention as well as afford the additional health benefits associated with a healthy, plant-based diet,” the authors write.

For more information visit