Information for General Practitioners

The TOPPITS study is a randomised controlled trial and aims to establish if PPIs are an effective treatment for persistent unexplained throat symptoms. Participants will be randomised to receive either Lansoprazole or placebo which they will take twice daily for 4 months.

Participants who meet the following criteria are eligible to take part:

  • Adults (over 18) referred with a persistent (over six weeks) primary throat symptom – globus, hoarseness, throat clearing, throat discomfort, choking spasms excess mucus/postnasal drip, otherwise unexplained night time cough or choking.
  • Score over 10 on the non-heartburn items of the Respiratory Symptoms Index.


Patient meeting any of the below criteria will not be eligible to take part:

  • those who do not wish to have a flexible laryngoscopy (photograph from inside) of their throat
  • those not able to complete the questionnaires for any reason.  
  • those diagnosed with head and neck or throat cancer,
  • those who use their voice professionally eg opera singers,
  • those who are allergic to the type of medicine used in the trial
  • those with liver failure, those taking clopidogrel (used to prevent heart attack or stroke), warfarin, Phenytoin (used to manage seizures), or some antifungal treatments. 
  • those who are HIV positive or taking antiviral medicines 
  • those who are pregnant or breastfeeding


If you have a patient that you think could be eligible to take part in this study and are local to one the six recruiting sites please do not hesitate to contact the study team at that site to discuss this further - contact details for the local site Principal Investigators can be found on the Study Team pages of this website.