Utility of 24-hour pharyngeal pH monitoring and clinical feature in laryngopharyngeal reflux disease

Wang, Gang; Qu, Changmin; Wang, Lei; Liu, Hongdan; Han, Haolun; Xu, Bin; Ying, Zhe; Li, Baowei; Zhang, Yiyan; Sun, Zhezhe; Gong, Jing; Li, Lianyong; Wu, Wei

doi:10.1080/00016489.2019.1571280

Cited by 14 publications

(9 citation statements)

References 19 publications

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“…Therefore, during an exacerbation of COPD, these symptoms would increase automatically, resulting in an increase in the RSI score, independently of LPR. Jung et al [17] found no association between RSI, RFS, and COPD severity or any other lung function parameter, except between RFS and residual volume / total lung capacity (%).We found no association between the questionnaire results (GerdQ-Questionnaire, RSI to assess reflux symptoms and the Leicester cough questionnaire to assess lifetime quality disturbance due to cough) and RYAN score results which confirms findings in other studies [23,24]. Currently, the main treatment for LPR is PPI.…”

Section: Discussionsupporting

confidence: 89%

Laryngopharyngeal reflux in chronic obstructive pulmonary disease - a multi-centre study

et al. 2020

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Reflux of gastric content has been associated with recurrent exacerbations of chronic obstructive pulmonary disease (COPD). We aimed to assess the prevalence of laryngopharyngeal reflux (LPR) in COPD and if LPR is a contributing factor to clinically relevant outcomes in COPD. We evaluated a total of 193 COPD patients (GOLD I-IV) with a 24-h laryngo-pharyngeal pΗ-monitor. LPR was observed in 65.8% of COPD patients and it was not significantly associated with clinically relevant outcomes of COPD. Treatment with PPI significantly decreased the upright RYAN score (p = 0.047) without improving lung function. Furthermore, the presence or severity of LPR cannot be diagnosed based solely on symptoms and questionnaires.

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Section: Discussionsupporting

confidence: 89%

Laryngopharyngeal reflux in chronic obstructive pulmonary disease - a multi-centre study

et al. 2020

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“…Other gastroenterologists agree with our opinion on these matters (23,24). Some researchers believe that age can affect the RSI diagnostic threshold for LPR (25), and another study using the Dx-pH system found that Ryan's scores, RSI, and RFS were poorly correlated with LPR detection (26).…”

Section: Discussionmentioning

confidence: 99%

Poor consistency between reflux symptom index and laryngopharyngeal pH monitoring in laryngopharyngeal reflux diagnosis in Chinese population

Wang¹,

Peng²,

Zhao³

et al. 2021

Ann Transl Med

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Background: It is unknown whether the reflux symptom index (RSI) can replace pH monitoring as a diagnostic tool for laryngopharyngeal reflux (LPR) in Chinese people. The relationships between reflux parameters and LPR symptoms also require further research.Methods: A total of 216 Chinese patients underwent laryngopharyngeal pH monitoring and filled out an RSI questionnaire. Laryngopharyngeal pH monitoring indicated a diagnosis of LPR for patients with 7 or more episodes of reflux or a reflex area index (RAI) of 6.3 or more. The RSI questionnaire indicated a diagnosis of LPR for patients with RSI scores of 14 or higher.Results: Of the 216 patients, 85 were diagnosed with LPR as assessed by the RSI, and 72 were diagnosed with LPR through laryngopharyngeal pH monitoring. The Cohen's kappa coefficient comparing LPR diagnosis consistency between RSI score and laryngopharyngeal pH monitoring was 0.133 (P=0.007). This indicated the two diagnostic methods were consistent to a low degree; the total consistency rate was only 59.7% (129/216). The sensitivity of the RSI was 48.6% (35/72), and its specificity was 82.5% (94/114

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“…The latter was first described in 2009 and has been validated by various research groups 7‐9 . Meanwhile, its reliability and reproducibility was proven to be high for extraoesophageal reflux assessment 10‐12 …”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9] Meanwhile, its reliability and reproducibility was proven to be high for extraoesophageal reflux assessment. [10][11][12]…”

mentioning

confidence: 99%

A novel scoring system for evaluating laryngopharyngeal reflux

Horvath

Hagmann

Burri

et al. 2021

Clinical Otolaryngology

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Risk factors for the development of reflux disease include increased gastric acid production, prolonged gastric emptying, restricted oesophageal clearance, reduced saliva secretion, increased intraabdominal pressure and sphincter insufficiency. Above all, acid, pepsin, bile salts and other gastroduodenal proteins cause mucosal irritation. Particularly, the combination of acid and pepsin tends to lead to mucosal damage, whereas the laryngopharyngeal mucosa is much more sensitive than the oesophageal mucosa due to a lack of defence mechanisms. 1,2 Gastro-oesophageal reflux (GER) and laryngopharyngeal reflux (LPR) are two different clinical entities, and a fundamental distinction needs to be made. GER often occurs at night and has classic reflux symptoms such as heartburn, acid regurgitation and retrosternal pain.In contrast, LPR occurs mostly during daytime and causes non-specific symptoms such as hoarseness, globus sensation, chronic throat clearing and increased mucus. 3 Nevertheless, GER and LPR can occur simultaneously and cause similar symptoms. 4 A correlation between various clinical pictures and GER has already been established. 5 These include reflux oesophagitis, oesophageal strictures, Barrett oesophagus and Barrett carcinoma. However, data for LPR are less clear.Various medical conditions seen on a daily basis such as chronic laryngopharyngitis, chronic sinusitis, bronchial asthma, pulmonary fibrosis and recurrent otitis media are associated with LPR. 6 Today, oesophago-gastro-duodenoscopy and impedance pH monitoring are the gold standard to assess GER. 5 In contrast, LPR is often diagnosed by clinical signs and symptoms and/or a trial of proton pump inhibitor (PPI) therapy. A few validated methods already exist to detect and quantify LPR, namely the reflux symptom index (RSI), the reflux finding score (RFS) and oropharyngeal pH monitoring (PHM). The latter was first described in 2009 and has been validated by various research groups. [7][8][9] Meanwhile, its reliability and reproducibility was proven to be high for extraoesophageal reflux assessment. [10][11][12]

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Utility of 24-hour pharyngeal pH monitoring and clinical feature in laryngopharyngeal reflux disease

Cited by 14 publications

References 19 publications

Laryngopharyngeal reflux in chronic obstructive pulmonary disease - a multi-centre study

Laryngopharyngeal reflux in chronic obstructive pulmonary disease - a multi-centre study

Poor consistency between reflux symptom index and laryngopharyngeal pH monitoring in laryngopharyngeal reflux diagnosis in Chinese population

A novel scoring system for evaluating laryngopharyngeal reflux

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