Objective Detection of Esophagopharyngeal Reflux in Patients With Hoarseness and Endoscopic Signs of Laryngeal Inflammation

Hayat, Jamal; Yazaki, Etsuro; Moore, A.; Hicklin, Lucy; Dettmar, Peter W.; Kang, Jin-Yong; Sifrim, Daniel

doi:10.1097/mcg.0000000000000011

Cited by 49 publications

(68 citation statements)

References 14 publications

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“…It is likely that the sensitivity of salivary pepsin testing could be improved by increasing the frequency of sampling and sampling when symptomatic. Previous studies have shown that patients with proximal reflux as defined by oesophageal pH or impedance testing have higher levels of pepsin in their saliva [24,33].…”

Section: Discussionmentioning

confidence: 99%

Detecting laryngopharyngeal reflux in patients with upper airways symptoms: Symptoms, signs or salivary pepsin?

Spyridoulias

Lillie

Vyas

et al. 2015

Respiratory Medicine

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Section: Discussionmentioning

confidence: 99%

Detecting laryngopharyngeal reflux in patients with upper airways symptoms: Symptoms, signs or salivary pepsin?

Spyridoulias

Lillie

Vyas

et al. 2015

Respiratory Medicine

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“…Recently, two new devices that overcome these limitations have been introduced for the detection of LPR: OP pH-metry (Respiratory Technology Corp.)[4-6] and hypopharyngeal multichannel intraluminal impedence (Sandhill Scientific Inc.)[25,26]. We used the OP Dx probe to detect acid reflux in the oropharynx of patients with clinically suspected LPR.…”

Section: Discussionmentioning

confidence: 99%

Oropharyngeal acid reflux and motility abnormalities of the proximal esophagus

Passaretti

Mazzoleni

Vailati

et al. 2016

WJG

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AIMTo investigate the relationship between pathological oropharyngeal (OP) acid exposure and esophageal motility in patients with extra-esophageal syndromes.METHODSIn this prospective study we enrolled consecutive outpatients with extra-esophageal symptoms suspected to be related to gastroesophageal reflux disease (GERD). We enrolled only patients with a reflux symptom index (RSI) score-higher than 13 and with previous lung, allergy and ear, nose and throat evaluations excluding other specific diagnoses. All patients underwent 24-h OP pH-metry with the Dx probe and esophageal high-resolution manometry (HRM). Patients were divided into two groups on the basis of a normal or pathological pH-metric finding (Ryan Score) and all manometric characteristics of the two groups were compared.RESULTSWe examined 135 patients with chronic extra-esophageal syndromes. Fifty-one were considered eligible for the study. Of these, 42 decided to participate in the protocol. Patients were divided into two groups on the basis of normal or pathological OP acid exposure. All the HRM parameters were compared for the two groups. Significant differences were found in the median upper esophageal sphincter resting pressure (median 71 mmHg vs 126 mmHg, P = 0.004) and the median proximal contractile integral (median 215.5 cm•mmHg•s vs 313.5 cm•mmHg•s, P = 0.039), both being lower in the group with pathological OP acid exposure, and the number of contractions with small or large breaks, which were more frequent in the same group. This group also had a larger number of peristaltic contractions with breaks in the 20 mmHg isobaric contour (38.7% vs 15.38%, P < 0.0001).CONCLUSIONIn patients with suspected GERD-related extra-esophageal syndromes pathological OP acid exposure was associated with weaker proximal esophageal motility.

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“…Other terms for the same phenomenon are extra esophageal reflux, laryngopharyngeal reflux (LPR), and silent reflux. The latter because heartburn and regurgitation which are typical symptoms of GORD may be absent [26]. Objective evidence of airway reflux may be obtained by impedance measurements or the detection of pepsin in saliva [27].…”

Section: Aetiology Of Chronic Coughmentioning

confidence: 99%

The Emerging Role of The Eosinophil and Its Measurement in Chronic Cough

Sadeghi¹,

Morice²

2017

TORMJ

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Although the aetiology of chronic cough in guidelines is clearly stated as asthma and related syndromes, gastro-oesophageal reflux disease (GORD), and upper airways disease, the inflammatory mechanisms underlying these conditions differ. Recent studies on asthma have increasingly focused on its molecular phenotypes instead of clinical characteristics. Here, we proposed the hypothesis that divides cough into two groups; the eosinophilic and neutrophilic. This division will enhance our ability to recognise the type of airway inflammation which, as a consequence will lead us to more targeted and personalized treatment approaches.

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Objective Detection of Esophagopharyngeal Reflux in Patients With Hoarseness and Endoscopic Signs of Laryngeal Inflammation

Abstract: A subgroup of patients with hoarseness (10/21) had objective detection of the esophagopharyngeal reflux. We propose that these patients are more likely to benefit from further intense antireflux therapy. Detection of pepsin in the saliva may be a useful screening tool in these patients.

Cited by 49 publications

References 14 publications

Detecting laryngopharyngeal reflux in patients with upper airways symptoms: Symptoms, signs or salivary pepsin?

Detecting laryngopharyngeal reflux in patients with upper airways symptoms: Symptoms, signs or salivary pepsin?

Oropharyngeal acid reflux and motility abnormalities of the proximal esophagus

The Emerging Role of The Eosinophil and Its Measurement in Chronic Cough

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