Does laryngopharyngeal reflux cause intraoral burning sensations? A preliminary study

Abstract

Intraoral burning sensations are a common problem in the otolaryngological practice. The aim of this study was to evaluate if laryngopharyngeal reflux can cause intraoral burning sensations by measuring oropharyngeal acid reflux. Patients with recurring intraoral burning sensations underwent oropharyngeal pH monitoring in our outpatient clinic. The pH catheter was placed at the level of the uvula. The catheter contained an externally worn transmitter, which wirelessly sent the data to a monitor. In addition, patients were instructed to indicate meals or the occurrence of burning sensations by pressing provided buttons on the monitor. Corresponding events of burning sensations and a significant decrease in oropharyngeal pH values should be visualized. Twenty two patients suffering from recurring intraoral burning sensations underwent oropharyngeal pH measurement for 21-25 h. We could find oropharyngeal reflux episodes in 11 patients. However, we could not detect any episodes of burning sensations in the mouth corresponding with a decrease in oropharyngeal pH values. Our results suggest that there is no causal connection between LPR episodes and the occurrence of intraoral burning sensations in the examined patients. Although further studies with more patients are necessary in the future, we conclude from our findings that recurring intraoral burning sensations are not an indication for proton pump inhibitor therapy.

Prevalence and Features of Laryngopharyngeal Reflux in Patients with Primary Burning Mouth Syndrome

“…3 In the same way, Becker et al observed that 50% of patients suffering from recurring intraoral burning sensations had pharyngeal reflux events at the oropharyngeal pH measurement. 14 However, these authors did not conclude a potential association between both conditions because they did not observe temporally significant association between reflux events and the symptom occurrence. 14 In the majority of these studies, the patient inclusion criteria were based on GERD diagnosis criteria, which yield the comparison of our results with limited studies in the literature.…”

“…14 However, these authors did not conclude a potential association between both conditions because they did not observe temporally significant association between reflux events and the symptom occurrence. 14 In the majority of these studies, the patient inclusion criteria were based on GERD diagnosis criteria, which yield the comparison of our results with limited studies in the literature. Only Becker et al based the diagnosis of reflux on pharyngeal events through an oropharyngeal device that exhibits different sensitivity and specificity from HEMII-pH.…”

“…So far, PPIs were commonly prescribed in patients with primary BMS and reflux findings. 14,21,22 From a pathophysiological standpoint, PPIs increase the pH of the gastric content and the related aerolized refluxate droplets in the upper aerodigestive tract mucosa, which may decrease the extracellular pepsin activity. 23 Because PPIs do not reduce the number and the duration of the pharyngeal reflux episodes, the gastric content (e.g., pepsin, lipase, trypsin, bile salts) may continue to refluxate through aerolized alkaline droplets in patients using only PPIs.…”

Enfrentamiento Práctico del Paciente con Síndrome de Boca Urente, una Propuesta para el Estudio y Tratamiento

“…19 Si bien el uso de los inhibidores de la bomba de protones en pacientes con SBU y RGE ha aumentado, puede que no sea necesariamente beneficioso; Becker et al no observaron conexión causal entre reflujo y sensación de ardor intraoral en una serie de 11 pacientes estudiados con ambas patologías. 20 Estudio salival: Una de las quejas más frecuentemente asociadas al SBU es la xerostomía, debido a esto, las alteraciones en el flujo salival como causa de SBU secundario deben ser descartadas mediante pruebas de sialometría no estimulada. 21 Estudio hormonal: en un estudio sobre mujeres con menopausia y molestias orales, Volpe et al encontraron que, con la suplementación de estrógenos, mejoraron los síntomas objetivos y subjetivos en 12 de 22 pacientes tratadas con estriol, y 7 de 10 pacientes tratadas con estrógenos conjugados asociados a noretisterona, por lo que las mujeres con receptores de estrógenos en la mucosa oral, pudieran disminuir la sintomatología con terapia de reemplazo hormonal, no pudiendo garantizarse que sea un tratamiento efectivo.…”

Burning Mouth Syndrome –Latest update

“…The lack of a correlation between laryngopharyngeal reflux and BMS has led to the conclusion that the prescription of omeprazole should be revised due to this drug's side effects and the modest benefits in using it to treat the condition 81 …”