Chronic Laryngitis Associated with Gastroesophageal Reflux: Prospective Assessment of Differences in Practice Patterns Between Gastroenterologists and ENT Physicians

Abstract

(1) Globus and throat clearing were considered the most useful symptoms in diagnosing GERD-related laryngitis, while laryngeal erythema and edema were considered the most useful signs for diagnosis and treatment of this condition by ENT physicians. However, these symptoms and signs may represent the least specific markers for reflux. (2) Many gastroenterologists perform pre-therapy testing which has low sensitivity in GERD-related laryngitis. (3) There is a dichotomy in treatment dose, duration, and perceived patient response to therapy between the two specialists. (4) Our study highlights a need for cross communication and education between these two disciplines in understanding and treating GERD-related laryngitis better.

Laryngopharyngeal reflux in patients with reflux esophagitis

“…In fact, this kind of report is quite rare in the literature. Most papers dealt only with the prevalence rate of GERD (ranging 20%-50%) in patients with LPR [4,21,23,24] . Our results indicated that age, hoarseness and a hiatus hernia could be the predicting factors of LPR in the patients with RE.…”

“…Among them, throat-clearing, persistent cough, globus and hoarseness are the most common complaints [24] . In our study, the prevalence of hoarseness in all the patients was 33.5%.…”

Management of laryngopharyngeal reflux with proton pump inhibitors

“…The most useful laryngeal signs for LPR are reported to be erythema, oedema, presence of a posterior commisure bar and cobble stoning (Ahmed, Khandwala, Abelson et al 2006). Recent data have documented a high intra-and interobserver variability of laryngeal examination, making the laryngoscopic diagnosis of LPR highly subjective.…”

“…There is a lack of consistent guidelines and consensus for the diagnosis of LPR (Ahmed et al 2006). The most common symptoms used to diagnose LPR include globus, throat clearing, cough, hoarseness, sore or burning throat, dysphagia, and dysphonia (Vaezi et al 2003).…”

“…However, these symptoms are not specifi c for refl ux induced damage and can also be associated with smoking, voice abuse, allergies, and viral infections. Prior reports have shown that less than 30% of patients with extraoesophageal manifestations of refl ux have endoscopic evidence of oesophagitis (Vaezi et al 2003;Ahmed et al 2006).…”