Prevalence of Esophagitis in Patients With pH‐Documented Laryngopharyngeal Reflux

Koufman, James A.; Belafsky, Peter C.; Bach, Kevin K.; Daniel, Elena; Postma, Gregory N.

doi:10.1097/00005537-200209000-00014

Cited by 102 publications

(93 citation statements)

References 16 publications

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“…However, it is not the exam of choice for diagnosing laryngopharyngeal reflux. Our results are similar to findings of some other authors (14,16) . Esophageal motor activity revealed that LES average pressure did not differ between patients with dysphonia and controls.…”

Section: Discussionsupporting

confidence: 94%

“…But, these authors did not exclude of the study, individuals using alcohol and tobacco, both factors that can cause lesions on larynx (18,22,32) . Female patients were more numerous among refluxers with dysphonia than in the control group (P = 0.047), as found by several authors (2,14,18,30) . Patients with dysphonia were older (46.8 ± 12.1 years) than the controls (39.1 ± 10.7 years; P = 0.02), suggesting a longer time of aggression to larynx epithelium.…”

Section: Discussionsupporting

confidence: 75%

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Gastroesophageal reflux disease and vocal disturbances

Henry

Martins

Lerco

et al. 2011

Arq. Gastroenterol.

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CONTEXT: Gastroesophageal reflux disease is a chronic disease in which gastroduodenal contents reflux into the esophagus. The clinical picture of gastroesophageal reflux disease is usually composed by heartburn and regurgitation (typical manifestations). Atypical manifestations (vocal disturbances and asthma) may also be complaint. OBJECTIVE: To analyse the clinical, endoscopic, manometric and pHmetric aspects of patients suffering from gastroesophageal reflux disease associated with vocal disturbances. METHODS: Fifty patients with gastroesophageal reflux disease were studied, including 25 with vocal disturbances (group 1 - G1) and 25 without these symptoms (group 2 - G2). All patients were submitted to endoscopy, manometry and esophageal pHmetry (2 probes). The group 1 patients were submitted to videolaryngoscopy. RESULTS: Endoscopic findings: non-erosive reflux disease was observed in 95% of G1 patients and 88% of G2. Videolaryngoscopy: vocal fold congestion, asymmetry, nodules and polyps were observed in G1 patients. Manometric findings: pressure in the lower esophageal sphincter (mm Hg): 11.6 ± 5.2 in G1 and 14.0 ± 6.2 in G2 (P = 0.14); pressure in the upper esophageal sphincter (mm Hg): 58.4 ± 15.9 in G1 and 69.5 ± 30.7 in the controls. pHmetric findings: De Meester index: 34.0 ± 20.9 in G1 and 15.4 ± 9.4 in G2 (P<0.001); number of reflux episodes in distal probe: 43.0 ± 20.4 in G1 and 26.4 ± 17.2 in G2 (P = 0.003); percentage of time with esophageal pH value lower than 4 units (distal sensor): 9.0% ± 6.4% in G1 and 3.4% ± 2.1% in G2 (P<0.001); number of reflux episodes in proximal probe: 7.5 ± 10.9 in G1 and 5.3 ± 5.7 in G2 (P = 0.38); percentage of time with esophageal pH values lower than 4 units (Proximal probe): 1.2 ± 2.7 in G1 and 0.5 ± 0.7 in G2 (P = 0.21). CONCLUSIONS: 1) The clinical, endoscopic, and manometric findings observed in patients with vocal disturbance do not differ from those without these symptoms; 2) gastroesophageal reflux intensity is higher in patients with vocal disturbance; 3) patients without vocal disturbance can also present reflux episodes in the proximal probe.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 75%

Gastroesophageal reflux disease and vocal disturbances

Henry

Martins

Lerco

et al. 2011

Arq. Gastroenterol.

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“…[12] Contrary to GER, complaints of heartburn and regurgitation are not frequently encountered in LPR. [13,14] Ossakow et al [11] reported that patients with complaints of reflux had been either treated in the outpatient clinics of ENT (earnose and throat) (n=63) or gastroenterology (GE) (n=36). The authors also compared signs and symptoms of the cases and detected episodes of hoarseness in 100% of ENT cases (in none of GE patients), while the corresponding rates of heartburn in the ENT and GE groups were reported in 6 and 89% of the cases, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, practical algorithms of history taking and differential diagnosis to be used for the diagnosis of LPR are needed. [5,8,10,13,15] In order to be able to evaluate LPR symptoms and their severity Belafsky et al [3] described a reflux finding scoring (RFS) system which interrogated frequently encountered 8 symptoms of LPR. Scores of RFS ranges from 0 to 26 points.…”

Section: Discussionmentioning

confidence: 99%

A pilot study on diagnosing laryngopharyngeal reflux disease by pharyngeal pH probe monitoring

Torun¹

2013

J Med Updates

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Gastroesophageal reflux (GER) is a spontaneous and effortless regurgitation of gastric contents into esophagus. However laryngopharyngeal reflux (LPR) is an atypical form of GER in which gastric contents severely regurgitate up to upper esophageal sphincter without retching or vomiting. Retrosternal burning sensation and regurgitation are Özet Amaç: Çal›flmam›zda larengofarengeal reflü (LFR) hastal›¤› olan ve sa¤l›kl› iki grup de¤erlendirilerek, Dx pH probunun LPR tan›s›nda sonuçlar›n› karfl›laflt›rmay› amaçlad›k.Yöntem: Di¤er hastal›klar ekarte edildikten sonra hem reflü semptom indeksi (RS‹) hem de reflü bulgu skoru (RBS) ile tipik skorlara sahip 57 LFR olgusu ile larengofarengeal yak›nmas› ve fizik muayene bulgular› olmayan 20 sa¤l›kl› gönüllü çal›flmaya al›nd›. Tüm olgulara RS‹ ve RBS formlar› dolduruldu. RS‹ <13 ve RBS <7 olanlar sa¤l›kl› grubu olufltururken RS‹ >13 ve RBS >7 olanlar LFR grubunu oluflturdu. ‹ki gruba Dx pH probu tak›larak veriler elde edildi. ‹statistiksel de¤erlendirmede Fisher'in kesin olas›l›k testi, Shapiro-Wilk testi, T testi ve Mann-Whitney testi kullan›ld›. p<0.05 istatistiksel olarak anlaml› kabul edildi. Bulgular: ‹ki grup aras›nda yafl, cinsiyet ve vücut kitle indeksi bak›-m›ndan istatistiksel fark saptanmad›. Sa¤l›kl› gönüllülerde ortalama pH de¤eri 6.97 saptan›rken hasta grupta 6.27 olarak hesapland› (p<0.05). pH olaylar›, pH <5.5 ve pH <5.0 de¤erleri için ayr› ayr› hesapland›; asit maruziyet süreleri de de¤erlendirilerek iki grup aras›n-da karfl›laflt›r›ld›¤›nda istatistiksel olarak anlaml› fark saptand› (p<0.05). Ayr›ca iki grubun pH olaylar› dik ve s›rtüstü pozisyonlarda ayr› ayr› hesaplanarak hem kendi içlerinde hem de gruplar aras›nda karfl›laflt›rma yap›ld›. Kendi içlerindeki k›yaslamalarda istatistiksel olarak anlaml› fark saptanamad› (p>0.05), ancak iki grup aras›nda bu k›yaslamada istatistiksel olarak anlaml› fark saptand› (p<0.05).Sonuç: Dx pH probu verileri RS‹ ve RBS de¤erleri ile k›yasland›¤›n-da tutarl› ve do¤ru sonuçlar elde edilmifltir. Larengofarengeal reflü tan›s›nda s›k kullan›lan di¤er yöntemlere alternatif olabilece¤i görül-müfltür.Anahtar sözcükler: Larengofarengeal reflü, reflü semptom indeksi, reflü bulgu skoru, farengeal pH probu. AbstractObjective: We aimed to evaluate (laryngopharyngeal reflux) LPR disease group and group with healthy volunteers and compare results obtained using Dx pH probe in the diagnosis of LPR disease.Methods: Fifty-seven LPR patients with typical scores of reflux symptom index (RSI) and reflux finding scoring (RFS) system and 20 healthy volunteers without laryngopharyngeal symptoms and physical examination findings were included in the study after excluding other concomitant diseases. All patients were requested to complete RSI and RFS forms. Healthy volunteers, with RSI <13 and RFS <7 constituted the control group and LPR group consisted of patients with RSI >13 and RFS >7. Dx pH probes were applied to each group. Fisher's exact test, Shapiro-Wilk test, T test and Mann-Whitney test were used for statistical analysis. A p value <...

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“…Pepsin has been recognized as the true marker and the responsible factor of mucosal damage [8][9][10][11][12]13]. Pepsin is a proteolytic enzyme originated in the stomach; it is present within the acid vapors.…”

Section: Introductionmentioning

confidence: 99%

Clinical-Diagnostic Correlations in Laryngopharyngeal Reflux (LPR). The Role of Peptesttm

Gelardi¹,

Eplite²,

Mezzina³

et al. 2017

IJOAOT

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LaryngoPharyngeal Reflux (LPR) is a term recently described, classified among the "extra-esophageal disorders", caused by another pathology called "Gastro-Esophageal Disease" (GED). Pepsin has been recognized as the true marker and the responsible factor of mucosal damage.The clinical-instrumental diagnosis of LPR is mainly based upon video laryngoscopy exam, pH-measuring, pH-impedance measuring, using "score" questionnaires, designed to establish the presence of specific symptoms (Reflux Symptom Index -RSI) and endoscopic signs (Reflux Finding Score -RFS). The evidence of the role of pepsin associated to the LPR helped to develop new technologies, able to detect the presence of that enzyme within the saliva; this device is called Peptest TMThe aim of the present study was to correlate the qualitativequantitative values of salivary pepsin (using Peptest TM ) with symptoms and signs obtained from RSI and RFS. The final goal is to validate this enzyme immunoassay method using LPR diagnostic tools.Seventy-five patients were recruited (41 females, 34 males) aged between 12 and 71 years old, (average age 45 years). All patients performed anamnesis, including food habits analysis, RSI evaluation, rhinofibrolaryngoscopy exam with RFS calculation and Peptest TM.Highly comparable results were obtained in all of the 75 patients undergoing double detection of Peptest TM , with LFD measure (T band intensity) and pepsin concentration (ng/ml).Statistically significant correlation concerning symptoms and saliva pepsin concentration was demonstrated as well as the relationship between objective signs and saliva pepsin concentration. The PeptestTM could become the "Gold standard" in all cases LPR pathology suspicion and may allow revealing the symptoms of that pathology at its early onset, avoiding dealing with more invasive methods and helping to adopt the correct therapeutic follow-up as soon as possible.

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Prevalence of Esophagitis in Patients With pH‐Documented Laryngopharyngeal Reflux

Cited by 102 publications

References 16 publications

Gastroesophageal reflux disease and vocal disturbances

Gastroesophageal reflux disease and vocal disturbances

A pilot study on diagnosing laryngopharyngeal reflux disease by pharyngeal pH probe monitoring

Clinical-Diagnostic Correlations in Laryngopharyngeal Reflux (LPR). The Role of Peptesttm

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