Magnesium Boosts PPI Therapy in Laryngopharyngeal Reflux: Indian Researchers Find

India: Laryngopharyngeal reflux (LPR), a condition caused by the backflow of stomach contents into the throat and voice box, remains an under-recognized yet troublesome disorder for many patients. Standard treatment relies heavily on proton pump inhibitors (PPIs), but a significant number of individuals continue to experience persistent symptoms despite therapy. A new study from NIMS University, Jaipur, published in the Indian Journal of Otolaryngology and Head & Neck Surgery, suggests that magnesium supplementation may improve outcomes when added to conventional treatment. Laryngopharyngeal reflux has long posed challenges for both patients and clinicians due to its subtle presentation and often incomplete response to conventional therapy. Symptoms such as chronic cough, throat clearing, hoarseness, and a sensation of a lump in the throat can significantly impair quality of life. By identifying magnesium as a potential adjunct therapy, this research opens the door for more comprehensive treatment approaches that may improve patient outcomes. The study, led by Dr. Neeti Sahay and colleagues from the Department of ENT, investigated whether magnesium supplementation could provide additional relief for LPR patients who typically struggle with lingering discomfort even on PPIs. Magnesium has previously been linked to esophageal motility and reflux control, but its role in LPR has not been systematically evaluated until now. For the trial, 68 patients diagnosed with LPR were randomly assigned to two groups. Group A, comprising 34 patients, received standard PPI therapy, while Group B, with 34 patients, was treated with PPIs in combination with magnesium oxide supplementation (400 mg/day). Clinical assessment included both symptom evaluation using the Reflux Symptom Index (RSI) and examination of the throat through laryngoscopy, scored using the Reflux Finding Score (RFS). Key Results Highlight the Benefit of Magnesium Supplementation Patients receiving magnesium in addition to PPIs showed greater improvement in both symptoms and laryngoscopic findings compared with those on PPIs alone. The mean reduction in Reflux Symptom Index (RSI) scores was 12.4 in the magnesium group versus 8.2 in the PPI-only group, a statistically significant difference. The decline in Reflux Finding Score (RFS), indicating reduced mucosal inflammation, was 6.1 in the magnesium group compared with 4.3 in the standard therapy group. These findings suggest that magnesium supplementation may enhance the effectiveness of PPIs in controlling LPR, possibly by improving esophageal motility and reducing the frequency of reflux episodes. The improvement in both symptom severity and objective laryngoscopic measures provides compelling evidence that magnesium could play a supportive role in the management of this condition. However, the authors caution that while the results are encouraging, the study was limited by its relatively small sample size. Larger, multi-center trials will be necessary to confirm the benefits and clarify the exact mechanisms through which magnesium exerts its protective effects in LPR. “Magnesium supplementation combined with PPI therapy shows promise in enhancing symptom relief and reducing inflammation in patients with LPR. While further research is needed, this simple and inexpensive addition to current treatment protocols may offer new hope for individuals struggling with persistent reflux-related throat problems," the authors concluded. Reference: Sahay, N., Yadav, A., Goyal, R. et al. Efficacy of Magnesium Supplementation in Laryngopharyngeal Reflux Disease: A Randomized Controlled Study. Indian J Otolaryngol Head Neck Surg (2025). https://doi.org/10.1007/s12070-025-06036-9