Quality of Life in Patients with Laryngopharyngeal Reflux

Abstract

Background: Laryngopharyngeal reflux (LPR) disease is an extraesophageal manifestation of gastroesophageal reflux disease (GERD). The impact of GERD-related LPR on the psychological well-being and quality of life (QOL) in Chinese is not known. Aim: To assess the QOL in patients with LPR disease. Methods: 76 LPR and 73 healthy subjects were recruited. Psychological well-being was assessed by the Hospital Anxiety and Depression Score and QOL was assessed by SF-36. Results: 51/76 (67.1%) patients had GERD-related LPR. More LPR subjects had taken sick leave (36.2 vs. 5.6%, p = 0.001) and reported adverse social life impact (60.5 vs. 38.9%, p = 0.013). LPR patients showed significantly worse results on the Voice Handicap Index (47.8 vs. 7.6, p = 0.001), were more anxious and had worse QOL in social functioning, pain and general health perception domains of SF-36. GERD-related LPR subjects had a higher depression score (4.8 vs. 3.8, p = 0.014) and a lower mental summary score (41.8 vs. 48.4, p = 0.01) in SF-36 compared with those without GERD. Conclusions: LPR had a negative impact on psychological status, social functioning and QOL. GERD symptoms appeared to be the main contributor to decrease QOL. GERD-related LPR patients had a significant impact on the mental component of their QOL.

The relationship between depressive symptoms and voice handicap index scores in laryngopharyngeal reflux

“…However, emotional domain scores did not differ between LPR patients and controls. These data are in contrast to the work of Cheung et al,7 who found worse scores for all VHI domains with a greater magnitude of scores reported, suggesting greater self‐perceived vocal impairment. In the original description of the VHI, the mean values for emotional scores were lower than those for functional and physical disability in patients with mild vocal impairment, in contrast to patients with moderate or severe vocal impairment in whom scores for all domains were greater in magnitude, and differences between domain scores were narrower 4.…”

“…Patients with LPR have greater impairment in the functional, physical, and emotional domains of the VHI compared with controls and with patients with GERD without extraesophageal symptoms 1, 5. Patients with LPR report significant reduction in health‐related quality of life, with significantly poorer scores in social functioning and anxiety, compared to controls 5–7. These data suggest that there is a significant emotional component to the burden of illness from LPR symptoms.…”

“…LPR has been reported to result in greater impairment in the functional, physical, and emotional domains of the VHI compared with controls, with physical domain score differences the most pronounced 13. The vocal dysfunction resulting from LPR significantly impacts social functioning and has been shown to be associated with work absenteeism and anxiety 5, 7…”

Typical symptoms rather than extraesophageal symptoms affect the quality of life in gastroesophageal reflux disease

“…When the study subjects with LPR symptoms were separated into a GERD-related and a non-related group, the subjects in the GERD-related group had a lower QoL (as diagnosed by the validated Chinese GERDQ and/or the presence of erosive esophagitis). The GERD symptoms, rather than the laryngopharyngeal symptoms, were the main contributors to the decrease in QoL in the LPR patients (19). In other words, GERD was the main cause of impaired QoL in patients with LPR.…”

Studying the Psychological Profile of Patients with Laryngopharyngeal Reflux

“…For example, globus pharyngeus, which is considered one of the common presentations of LPR, has often been attributed to psychiatric problems [7]. Previous studies also reported that LPR patients had significantly increased psychological distress compared to healthy subjects, which could negatively influence the quality of life [8,9]. …”