Laryngopharyngeal reflux: Comparing improvements in reflux symptom index with reflux finding score

Hutnik, Robert; Zlatopolsky, Aaron; Mehraban-Far, Sina; Alrassi, James; McMillan, Nadia; Amadi, Chima; Fujita, Kevin; Mortensen, Melissa

doi:10.1016/j.amjoto.2020.102730

Cited by 10 publications

(11 citation statements)

References 16 publications

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“…erefore, in a follow-up trial the investigators will be looking more closely at the response to eradication in HP-positive patients divided into eradicated and noneradicated patients. Finally, we consider that although 14 C-UBT is proven to be safe, appropriate safety precautions must be taken for the storage, handling, and disposal of the radioactive test components. Our next step may be to choose the 13 C isotope, as it is nonradioactive.…”

Section: Discussionmentioning

confidence: 99%

“…Reflux symptom index (RSI) [ 13 , 14 ] is a 9-item patient questionnaire scoring system used to assess severity of reflux symptoms. The parameters tested included hoarseness or dysphonia, chronic cough, difficulty swallowing, excess laryngeal secretions, heartburn or regurgitation, difficulty breathing, constant throat clearing, throat pain, and foreign-body sensation in the throat.…”

Section: Methodsmentioning

confidence: 99%

“…The total score of RSI was 45. Reflux finding score (RFS) [ 14 , 15 ] is a 8-item clinical severity scale based on laryngoscopic findings. The parameters included subglottic edema, ventricular obliteration, mucosal hyperemia, vocal cord edema, laryngeal edema, posterior commissure hypertrophy, and thick endolaryngeal mucus.…”

Section: Methodsmentioning

confidence: 99%

“…Hp infection was examined using the 14 C urea breath test [11]. Briefly, all the participants took an urea 14 C capsule on an empty stomach 15 min before tests.…”

Section: Hp Detectionmentioning

confidence: 99%

“…e 14 C content in the gas blew out from the patients was recorded by a YH04E Hp detector. e 14 C results (expressed in dmp) were defined as: ≤99 dmp, negative; 99< dpm ≤149, uncertain; dpm >149, positive; 149< dpm ≤499, "+"; 499< dpm ≤1499, "++"; 1499< dpm ≤2499, "+++"; dpm >249, "++++. "…”

Section: Hp Detectionmentioning

confidence: 99%

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Impact of Helicobacter pylori Infection and Outcome of Anti-Helicobacter pylori Therapy in Patients with Reflux Laryngopharyngitis

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objectives. This study was designed to explore the relationship between Helicobacter pylori (Hp) infection and reflux laryngopharyngitis (RLP) and to evaluate the outcome of anti-Hp therapy in improving RLP symptoms. Methods. A total of 410 patients with RLP were enrolled and tested for Hp infection. The association of Hp infection with reflux symptom index (RSI) and reflux finding score (RFS) was determined. Hp-positive patients received either a proton pump inhibitor (PPI) omeprazole alone (control group) or a combination regimen (experimental group) consisting of omeprazole, mosapride citrate, amoxicillin, and clarithromycin. Therapeutic outcomes were compared 4 weeks later. Results. Of the 410 participants, 290 were Hp-positive and 120 Hp-negative. Both RSI and RFS were significantly higher in Hp-positive patients than in Hp-negative patients. Hp infection status was positively correlated with RSI ( P < 0.05 ) and RFS ( P < 0.05 ). The overall response rate was higher in the experimental group than in the control group. Both the groups had a significant reduction in RSI and RFS after therapy, with a greater improvement in the experimental group ( P < 0.05 ). Conclusion. Our findings establish a link between Hp infection and RLP. Anti-Hp therapy improves RSI and RFS in RLP patients. Therefore, Hp eradication drugs may be added to the PPI-based regimen in the treatment of RLP.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Hp infection was examined using the 14 C urea breath test [11]. Briefly, all the participants took an urea 14 C capsule on an empty stomach 15 min before tests.…”

Section: Hp Detectionmentioning

confidence: 99%

Section: Hp Detectionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of Helicobacter pylori Infection and Outcome of Anti-Helicobacter pylori Therapy in Patients with Reflux Laryngopharyngitis

Chen

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Correlation of Esophageal Mean Nocturnal Baseline Impedance With Markers of Laryngopharyngeal Reflux

et al. 2022

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Objectives: Mean nocturnal baseline impedance (MNBI) is a measure of the esophageal epithelial barrier function calculated via high-resolution impedance manometry and can be used as a diagnostic tool and treatment response predictor for gastroesophageal reflux disease (GERD). However, its utility for laryngopharyngeal reflux (LPR) has been minimally studied. We aimed to investigate the relationship of MNBI between patients with suspected LPR, healthy controls, and their 24-h multichannel intraluminal impedance-pH (MII-pH) study results.Methods: Retrospective patient series analysis was performed of patients with suspected LPR and healthy controls who underwent 24-h MII-pH monitoring. MNBI values were calculated from impedance channels at the level of the hypopharynx, proximal esophagus, and distal esophagus. We compared these MNBI values between the subject groups with secondary analysis on MII-pH results, reflux symptom index, reflux findings score, DeMeester score, and salivary pepsin levels.Results: Twenty-three patients with suspected LPR and 14 healthy controls were enrolled. Decreased distal esophageal MNBI was found to be significantly decreased in patients with suspected LPR compared with healthy controls (p < 0.01) and in subjects with positive MII-pH studies compared to negative MII-pH studies (p < 0.01). There were no significant correlations of MNBI at the hypopharynx or proximal esophagus.Conclusion: Distal esophageal MNBI has significant correlations with many phenotypic and biological markers of LPR. These findings indicate that MNBI has the potential to be applied to LPR, similar to its emerging use as a diagnostic tool and treatment response predictor for GERD.

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Esophageal Baseline Impedance is Associated with Laryngopharyngeal Reflux and Treatment Response

Kurylo,

Noel,

Blumin

et al. 2024

The Laryngoscope

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ObjectiveTo evaluate the efficacy of distal esophageal mean nocturnal baseline impedance (MNBI), a general marker of esophageal mucosal barrier integrity, in predicting laryngopharyngeal reflux (LPR) and symptomatic response to acid reflux therapy.MethodsThis retrospective study analyzed 173 patients who presented with symptoms of laryngopharyngeal reflux and underwent 24‐h multichannel intraluminal impedance‐pH (MII‐pH) testing. Mean nocturnal baseline impedance values were calculated and assessed for their association and ability to predict LPR symptoms, MII‐pH results, treatment response, and other markers of LPR.ResultsNotably, 153 of the 173 patients were tested off acid suppression medication and included in statistical analysis. Based on the MII‐pH probe data, 108 (71%) patients had LPR, 8 (5%) had gastroesophageal reflux disease (GERD), and 37 (24%) were without pathologic reflux. Distal esophageal MNBI of LPR patients was significantly lower in LPR patients than patients with negative studies (1332 ± 94.8 vs. 2158 ± 173.5, p = 0.001). Among 118 patients who trialed antireflux therapy, a distal esophageal MNBI cutoff value of <1580 Ω was an independent predictor of treatment response (OR = 4.148 [1.877–9.189]). This value better predicted improvement with antireflux therapy for LPR than other objective MII‐pH probe data, which were not independent predictors of treatment response.ConclusionDistal esophageal MNBI values may have value in the diagnosis of LPR and potentially predict medication responsiveness in LPR patients.Level of Evidence3 Laryngoscope, 2024

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Laryngopharyngeal reflux: Comparing improvements in reflux symptom index with reflux finding score

Cited by 10 publications

References 16 publications

Impact of Helicobacter pylori Infection and Outcome of Anti-Helicobacter pylori Therapy in Patients with Reflux Laryngopharyngitis

Impact of Helicobacter pylori Infection and Outcome of Anti-Helicobacter pylori Therapy in Patients with Reflux Laryngopharyngitis

Correlation of Esophageal Mean Nocturnal Baseline Impedance With Markers of Laryngopharyngeal Reflux

Esophageal Baseline Impedance is Associated with Laryngopharyngeal Reflux and Treatment Response

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