Patients with acid, high-fat and low-protein diet have higher laryngopharyngeal reflux episodes at the impedance-pH monitoring

Lechien, Jérôme R.; Bobin, François; Muls, Vinciane; Horoi, Mihaéla; Thill, Marie Paule; Dequanter, Didier; Rodriguez, Alexandra; Saussez, Sven

doi:10.1007/s00405-019-05711-2

Cited by 56 publications

(57 citation statements)

References 52 publications

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“…If subjects ate largely highly refluxogenic foods/beverages over the past 3 weeks, then the GRES will be high. A high GRES is associated with a high number of proximal reflux episodes . Once the reflux had been confirmed, the patient received diet recommendations based on a personalized diet grid excluding refluxogenic foods and beverages.…”

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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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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“…Laryngopharyngeal reflux (LPR) is an inflammatory condition of the upper aerodigestive tract tissues related to direct and indirect effect of gastroduodenal content reflux, which induces morphological changes in the upper aerodigestive tract [1]. The incidence of LPR-associated symptoms ranges from 10 to 30% of people of Western countries [2,3] and would be increasing concerning the changes in a modern lifestyle and dietary habits [4]. The LPR is involved in the development of many otolaryngological diseases through the deposit of gastroduodenal enzymes into the mucosa of the upper aerodigestive tract.…”

Section: Introductionmentioning

confidence: 99%

Laryngopharyngeal reflux, gastroesophageal reflux and dental disorders: A systematic review

Lechien¹,

Chiesa‐Estomba

Henriquez³

et al. 2020

PLoS ONE

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Objectives To investigate the role of gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) in the development of dental disorders. Methods The first outcome was review of the role of reflux in the development of dental disorders in adults. The second outcome was review of the potential pathophysiological mechanisms underlying the association between reflux and dental disorders. Three investigators screened publications for eligibility and exclusion based on predetermined criteria through a literature search conducted on PubMed, Cochrane Library, and Scopus according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results From 386 publications, 24 studies were kept for analysis. Objective approaches were used in 16 studies to confirm GERD diagnosis. Pharyngeal reflux episodes (LPR) were considered in 2 studies. No study considered nonacid reflux. The study results supported a higher prevalence of dental erosion and caries in reflux patients compared with healthy individuals.

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“…According to a recent meta‐analysis, the sensitivity and the specificity of saliva pepsin measurement are 64% and 68%, respectively, 5 the sensitivity depending on the method used for the pepsin measurement and many unknown factors 1,6 . The diet of the patient could be one of these unknown factors regarding a recent study reporting a significant association between the patient's diet and the occurrence of hypopharyngeal reflux episodes at the hypopharyngeal–esophageal intraluminal multichannel impedance‐pH monitoring (HEMII‐pH) 7 . To date, there are no data in the literature about the potential impact of foods and beverages consumed by LPR patients on the measurement of the saliva pepsin concentration.…”

Section: Introductionmentioning

confidence: 99%

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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Patients with acid, high-fat and low-protein diet have higher laryngopharyngeal reflux episodes at the impedance-pH monitoring

Cited by 56 publications

References 52 publications

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

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

Laryngopharyngeal reflux, gastroesophageal reflux and dental disorders: A systematic review

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

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