The Time‑Point Distribution Characteristics of Laryngopharyngeal Reflux in Elderly Patients

Abstract

ObjectiveTo identify the characteristics of the time‐point distribution of the occurrence of hypopharyngeal‐proximal reflux episodes (HREs) in elderly and younger patients with laryngopharyngeal reflux (LPR).Study DesignRetrospective cohort study.SettingAnalysis of data from patients with LPR‐related symptoms and 24‑hour hypopharyngeal‐esophageal multichannel intraluminal impedance‐pH (24‐hour HEMII‑pH) monitoring from February 2017 to September 2022 at Sixth Medical Center of PLA General Hospital.MethodsPatients were divided into 2 age groups: the elderly group (>60 years) and the younger group (≤60 years). The time series of HREs and meals within 24 hours were analyzed based on HEMII‑pH.ResultsA total of 305 patients were included (126 elderly patients). In younger patients, except for nonacid‐gas HREs, the incidence of the remaining types of HREs tended to increase within 2 hours after meals, especially after dinner. The incidence of all types of HREs pre‐ and postmeal was not significantly different in the elderly group (χ2 = 0.080, P = .777). The incidence of nighttime HREs in elderly patients was statistically higher than in younger patients (6.23% vs 3.96%, P = .030), particularly acid‐/nonacid‐liquid HREs.ConclusionHREs tend to increase within 2 hours after meals in younger LPR patients, except for nonacid‐gas HREs. In elderly LPR patients, the incidence of all types of HREs pre‐ and postmeal were not significantly different, and nighttime fluid HREs was more prone to occur than in younger patients.

In Response to The Dubai Definition and Diagnostic Criteria of Laryngopharyngeal Reflux: The IFOS Consensus

“…Anatomic reflux events into the pharynx from the esophagus, more correctly called "HRE" correctly describe reflux events that do not necessarily make it into the larynx. 1,3 Thus, the term "laryngopharyngeal reflux" is a commonly offered shorthand, 4,5 often used in the literature to represent the disease state of LPR, 4,5 and describes the related histopathological consequences, for example, laryngopharyngeal findings. 4 Despite Hoppo et al describing the finding of ≥1 HRE being outside HEMII-pH normative values, there is no evidence that one HRE should be accepted as the cause of the patient's symptoms.…”