Development of scores assessing the refluxogenic potential of diet of patients with laryngopharyngeal reflux

Lechien, Jérôme R.; Bobin, François; Mouawad, F.; Zeleník, Karol; Calvo-Henríquez, Christian; Chiesa‐Estomba, Carlos Miguel; Enver, Necati; Nacci, Andrea; Barillari, Maria Rosaria; Schindler, Antonio; Crevier‐Buchman, Lise; Hans, Stéphane; Simeone, V.; Włodarczyk, Elżbieta; Harmegnies, Bernard; Remacle, Marc; Rodriguez, Alexandra; Dequanter, Didier; Eisendrath, Pierre; Dapri, Giovanni; Finck, Camille; Karkos, Petros D.; Pendleton, Hillevi; Ayad, Tareck; Muls, Vinciane; Saussez, Sven

doi:10.1007/s00405-019-05631-1

Cited by 32 publications

(44 citation statements)

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“…This classification of foods and beverages was based on the calculation of a score assessing the refluxogenic potential of foods and beverages (Refluxogenic Diet Score [REDS]). The REDS considers pH, fat, protein, sugar composition, and other specific factors 12 . From the patient anamnesis, the authors calculated the Global Refluxonic Score (GRES), which consists of the addition of REDS of foods and beverages that have been consumed by patients over the past 2 weeks.…”

Section: Methodsmentioning

confidence: 99%

“…From the patient anamnesis, the authors calculated the Global Refluxonic Score (GRES), which consists of the addition of REDS of foods and beverages that have been consumed by patients over the past 2 weeks. The refluxogenic potential of foods and beverages that have been consumed during the 24‐hour HEMII‐pH testing (and before the saliva sample collections) was evaluated through the Refluxogenic Score of a Dish (RESDI), which consists of the weighted sum of the REDS of foods and beverages consumed during a meal 12 . The RESDI may be calculated as absolute (sum of all RESDIs of the testing period) or mean (mean of all RESDIs of the testing period).…”

Section: Methodsmentioning

confidence: 99%

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Saliva Pepsin Concentration of Laryngopharyngeal Reflux Patients Is Influenced by Meals Consumed Before the Samples

et al. 2020

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Objectives/Hypothesis To assess the impact of diet on the saliva pepsin concentration of patients with laryngopharyngeal reflux (LPR). Study Design Non‐controlled Prospective Study. Methods Patients with positive LPR regarding hypopharyngeal–esophageal impedance‐pH monitoring (HEMII‐pH) were enrolled from three European Hospitals. Patients collected three saliva samples, respectively, in the morning (fasting), and 1 to 2 hour after lunch and dinner. Patients carefully detailed foods and beverages consumed during meals and before the pepsin samples. The 3‐month treatment was based on the association of diet, proton pump inhibitors, alginate, or magaldrate regarding the HEMII‐pH characteristics. Reflux Symptom Score (RSS) and Reflux Sign Assessment (RSA) were used for assessing the pre‐ to posttreatment clinical evolution. The Refluxogenic Diet Score and the Refluxogenic Score of a Dish (RESDI) were used to assess the refluxogenic potential of foods and beverages. The relationship between saliva pepsin concentration, HEMII‐pH, RESDI, RSS, and RSA was investigated through multiple linear regression. Results Forty‐two patients were included. The saliva pepsin concentration of the 24‐hour period of testing was significantly associated with foods and beverages consumed during the testing period and the evening dinner (rs = 0.973, P < .001). RSS and RSA significantly improved throughout treatment. The level of saliva pepsin in the morning was a negative predictive factor of the therapeutic response regarding RSA and RSS (P < .036). Conclusions Foods and beverages may significantly impact the saliva pepsin concentration of patients with LPR. Patients with high‐level saliva pepsin in the morning had lower therapeutic response compared with those with low‐level saliva pepsin. Level of Evidence 4 Laryngoscope, 131:350–359, 2021

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Saliva Pepsin Concentration of Laryngopharyngeal Reflux Patients Is Influenced by Meals Consumed Before the Samples

et al. 2020

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“…GRES is a score rating the refluxogenic potential of Western European foods and beverages that are usually consumed by European people. The calculation of GRES has been described in a previous publication . Overall, GRES is based on the Refluxogenic Diet Score (REDS), classifying foods and beverages in five categories from very low refluxogenic food/beverage (cat.1) to very high refluxogenic food/beverage (cat.5) .…”

Section: Methodsmentioning

confidence: 99%

“…The calculation of GRES has been described in a previous publication . Overall, GRES is based on the Refluxogenic Diet Score (REDS), classifying foods and beverages in five categories from very low refluxogenic food/beverage (cat.1) to very high refluxogenic food/beverage (cat.5) . If subjects ate largely highly refluxogenic foods/beverages over the past 3 weeks, then the GRES will be high.…”

Section: Methodsmentioning

confidence: 99%

Gastroesophageal reflux in laryngopharyngeal reflux patients: Clinical features and therapeutic response

Lechien¹,

Bobin²,

Muls

et al. 2019

The Laryngoscope

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Objective To investigate the clinical features and the therapeutic response of laryngopharyngeal reflux (LPR) patients with or without gastroesophageal reflux disease (GERD). Methods Patients with LPR symptoms were enrolled from three European Hospitals. The diagnosis of LPR and GERD was made through impedance‐pH monitoring (MII‐pH). A gastrointestinal endoscopy was realized in patients with digestive complaints or ≥60 years old. The 3‐ to 6‐month treatment was based on the association of diet, pantoprazole, alginate, and magaldrate regarding the MII‐pH characteristics. Reflux Symptom Score (RSS) and Reflux Sign Assessment (RSA) were used to evaluate the clinical evolution throughout treatment. The gastrointestinal endoscopy findings, clinical features, and therapeutic response were compared between patients with LPR and GERD (LPR/GERD) and patients with LPR. Results One hundred and eleven LPR patients were included, 54 being LPR/GERD. LPR/GERD patients had a higher number of proximal reflux episodes compared with LPR patients. The prevalence of esophagitis, hernia hiatal, and lower esophageal sphincter insufficiency did not differ between groups. The presence of GERD was strongly associated with acid LPR. Patients without GERD had a higher proportion of nonacid and mixed LPR compared with LPR/GERD patients. The pre‐ to posttreatment evolutions of RSS and RSA were quite similar in both groups, with the exception of the 3‐ to 6‐month improvement of digestive symptoms, which was better in LPR/GERD group. The therapeutic success rates were 79.6% and 77.2% in GERD/LPR and LPR group, respectively. Conclusion GERD is predictive of acid LPR. The clinical evolution and the therapeutic response rates were quite similar in both groups. Level of Evidence 4 Laryngoscope, 130: E479–E489, 2020

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“…Abbreviations: PPISs = proton pump inhibitors. [84,85]. Some foods may be upgraded or downgraded regarding to characteristics.…”

Section: Cost-effective Empirical Approachmentioning

confidence: 99%

Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians

Lechien

Saussez

Muls

et al. 2020

JCM

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Laryngopharyngeal reflux (LPR) is a common disease in the general population with acute or chronic symptoms. LPR is often misdiagnosed in primary care because of the lack of typical gastroesophageal reflux disease (GERD) symptoms and findings on endoscopy. Depending on the physician’s specialty and experience, LPR may be over- or under-diagnosed. Management of LPR is potentially entirely feasible in primary care as long as General Practitioners (GPs) are aware of certain “red flags” that will prompt referral to a Gastroenterologist or an Otolaryngologist. The use of patient-reported outcome questionnaires and the consideration of some easy ways to diagnose LPR without special instrumentation oropharyngeal findings may help the GP to diagnose and often manage LPR. In this review, we provide a practical algorithm for LPR management for GPs and other specialists that cannot perform fiberoptic examination. In this algorithm, physicians have to exclude some confounding conditions such as allergy or other causes of pharyngolaryngitis and “red flags”. They may prescribe an empirical treatment based on diet and behavioral changes with or without medication, depending on the symptom severity. Proton pump inhibitors and alginates remain a popular choice in order to protect the upper aerodigestive tract mucosa from acid, weakly acid and alkaline pharyngeal reflux events.

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Development of scores assessing the refluxogenic potential of diet of patients with laryngopharyngeal reflux

Cited by 32 publications

References 88 publications

Saliva Pepsin Concentration of Laryngopharyngeal Reflux Patients Is Influenced by Meals Consumed Before the Samples

Saliva Pepsin Concentration of Laryngopharyngeal Reflux Patients Is Influenced by Meals Consumed Before the Samples

Gastroesophageal reflux in laryngopharyngeal reflux patients: Clinical features and therapeutic response

Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians

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