Prevalence and clinical predictors of LPR among patients diagnosed with GERD according to the reflux symptom index questionnaire

Abstract

Background/Aims:Gastroesophageal reflux disease (GERD) is a common condition that can lead to significant morbidity. Laryngopharyngeal reflux (LPR) is a distinct clinical entity that can occur simultaneously with GERD, necessitating additional treatment measures. The degree of overlap and clinical predictors of LPR among patients with GERD remains unknown. We aim to measure the prevalence of LPR in patients with GERD and identify clinical predictors.Patients and Methods:We performed a cross-sectional study involving patients with confirmed GERD according to the GERD questionnaire (GerdQ) using the reflux symptom index (RSI). Data on demographics, comorbidities, past and current medications, and GERD-related lifestyle measures were documented. The prevalence of LPR was calculated. Linear and logistic regression analyses were conducted to correlate GerdQ and RSI, and to identify clinical predictors of LPR, respectively.Results:A total of 80 patients with confirmed GERD were consecutively recruited and surveyed. Mean age was 43 (±16) and 60% were females. The majority of patients were Saudis (51%) and only 24% were smokers. The mean duration of GERD was 7 (±4.4) years and the average body mass index (BMI) was 36 ± 22. Sixty-six percent of the patients consumed coffee on regular basis. On simple and multiple linear regression analyses, a strong, positive correlation was observed between the GerdQ and RSI scores (coefficient = 1.13, 95%CI = 0.39–1.86), and ipratropium bromide inhaler was positively associated with RSI scores (coefficient = 13.12, 95%CI = 0.16–26.09). LPR was identified in 57 patients (71%). On simple and multiple logistic regression analyses, GerdQ scores (OR = 1.78, 95%CI = 1.13–2.80), BMI (OR = 1.07, 95%CI = 1.01–1.14), duration of GERD in years (OR = 1.42, 95%CI = 1.04–1.93), and the type of gender (OR = 49.67, 95%CI = 1.32–1870) appeared to increase the risk of LPR, whereas coffee consumption (OR = 0.0005, 95%CI = 1.82e–06, 0.13) appeared to be negatively associated with LPR.Conclusions:Contradictory to what is frequently reported, LPR commonly occurs and positively correlates with GERD. Several modifiable clinical predictors of LPR might exist, which highlight the importance of performing a complete clinical assessment of the patients with reflux symptoms.

Management of Laryngopharyngeal Reflux in Asia

“…Furthermore, more Eastern Asian otolaryngologists prescribed GI endoscopy for patients complaining of heartburn or stomach acid coming up than Western Asian otolaryngologists. For three decades, the overall trend has been to consider LPR and GERD to be different diseases [ 2 , 28 ], but many studies have shown a relationship between the two diseases [ 29 , 30 ]. Thus, digestive symptoms such as heartburn and regurgitation—both considered to be major symptoms of GERD—should be carefully evaluated when diagnosing LPR [ 13 ].…”

“…Laryngopharyngeal reflux (LPR)—also known as extraesophageal reflux—is an inflammatory condition of the upper aerodigestive tract related to the direct and indirect effects of gastric or duodenal content reflux, which induces morphological changes in the upper aerodigestive tract [ 1 ]. Gastroesophageal reflux disease (GERD) is also caused by the reflux of gastric content, but the two conditions show many differences in symptoms, manifestations, and response to treatment [ 2 ]. The most important difference between LPR and GERD is that the majority of patients with LPR do not have esophagitis; furthermore, fewer digestive-related symptoms are generally reported in patients with GERD [ 3 ].…”

Laryngopharyngeal Reflux: Effect of Race and Insurance Status on Symptomology

“…3 Both mechanisms alter the local physiology of the larynx and its surrounding structures leading to varying degrees of dysphonia, hoarseness, nonproductive throat clearing, sensation of postnasal drip, globus pharyngeus, and cough. 1 As health and healthcare inequities persist throughout the United States, there remains a lack of literature addressing disparities in LPR. 4 Over the last decade, the diagnosis of LPR has increased by 500%, accounting for nearly 10% of Otolaryngologic visits, and affects all racial and ethnic groups in the US.…”

Non-Surgical Animal Model of Gastroesophageal Reflux Disease by Overeating Induced in Mice

“… 1 Approximately half of all adults experience symptoms in their lives. 2 3 Among the various causes, acid and bile juice reflux into the esophageal mucosa are known to be the main causes. 4 5 Diverse types of management, such as lifestyle modifications, medications, endoscopic intervention and surgery are adopted for treatment of GERD.…”