As LPR diagnostic work-up is complex in the absence of a definitive gold standard diagnostic test, patient symptoms have become a primary method to identify those with LPR. In this regard, Reflux Symptom Index (RSI) is a reliable self-administered questionnaire useful also to monitor changes after treatment. An Italian survey on patients with LPR evaluated the effect of treatments for LPR that were prescribed in a real-world setting, such as Otolaryngological clinics. In this part of the survey, 1,680 subjects [45.2% males, 54.8% females, 50.4 (14.7) years] were visited in the 86 Italian ORL centers. About 70% of patients were treated with Marial® alone, 27% with PPI plus add-on. RSI change assessment was the primary outcome. Both therapeutic options significantly (p<0.0001) reduced RSI score interestingly since the second week. The inter-group comparison demonstrated the Marial® monotherapy induced a greater reduction of RSI than PPI plus add-on since the second week. In conclusion, the present survey reported that a new medical device (Marial®) may be considered a valid option for the treatment of LPR.