Question:medium
Gold standard test for diagnosis of laryngopharyngeal reflux?
Gold standard test for diagnosis of laryngopharyngeal reflux?
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Look for the test that objectively measures acid reaching the pharynx.
Updated On: Jun 24, 2026
- 24-hour double-probe pH monitoring
- Flexible endoscopy
- Barium swallow
- Laryngoscopy
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The Correct Option is A
Solution and Explanation
To label a patient as having laryngopharyngeal reflux with certainty, a clinician must prove that acid is physically reaching the throat rather than rely on appearance alone. The investigation that delivers this proof is ambulatory pH testing performed over a full day using two sensors, one positioned low in the oesophagus and the other high near the larynx and pharynx. By logging every acid event over twenty-four hours, this double-probe study directly measures pharyngeal acid exposure, which is exactly what defines the disease, making it the reference standard. The competing options all fall short. Flexible endoscopy and laryngoscopy reveal mucosal changes such as redness and swelling that overlap heavily with other irritants and therefore lack specificity. A barium swallow is mainly an anatomical study and misses the intermittent acid exposure of LPR. Since only one test objectively quantifies acid reaching the upper airway, the dual-probe twenty-four-hour pH monitor stands out.
\[\boxed{\text{24-hour double-probe pH monitoring}}\]
\[\boxed{\text{24-hour double-probe pH monitoring}}\]
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