scholarly journals Relationship between laryngopharyngeal reflux disease and gastroesophageal reflux disease based on synchronous esophageal and oropharyngeal Dx-pH monitoring

2020 ◽  
Vol 41 (3) ◽  
pp. 102441 ◽  
Author(s):  
Lei Wang ◽  
Gang Wang ◽  
Lianyong Li ◽  
Xin Fan ◽  
Hongdan Liu ◽  
...  
2009 ◽  
Vol 123 (S31) ◽  
pp. 42-47 ◽  
Author(s):  
K Sato ◽  
H Umeno ◽  
S Chitose ◽  
T Nakashima

AbstractObjectives:Double-probe, 24-hour pH monitoring remains the ‘gold standard’ for the diagnosis of laryngopharyngeal reflux disease, even though there is no consensus on how to interpret the data collected.Methods:Tetra-probe, 24-hour pH monitoring was performed in 56 patients with suspected laryngopharyngeal reflux, in order to investigate patterns of laryngopharyngeal and gastroesophageal reflux.Results:The number of reflux episodes and the total and percentage time periods spent with pH < 4.0 were correlated with the distance of the probe from the lower oesophageal sphincter. The number of reflux episodes and the total and percentage time periods with pH < 4.0 were greater when patients were upright (i.e. during the daytime). There were few laryngopharyngeal reflux events recorded for pH levels of <4.0; however, there were a significant number of laryngopharyngeal reflux events recorded for pH levels of <5.0, a level capable of causing laryngopharyngeal reflux disease. When a pH level of <5.0 was used, the number, total time and percentage time of laryngopharyngeal reflux episodes was greater during the supine period (i.e. during sleeping) in a quarter of the cases, compared with results when a pH of <4.0 was used.Conclusions:It is valid to use a pH level of 5.0 as indicative of laryngopharyngeal reflux in the hypopharynx.


2020 ◽  
pp. 014556132097191
Author(s):  
Yun Wu ◽  
Junyao Wang ◽  
Qing Huang ◽  
Tao Peng ◽  
Lili Zhao ◽  
...  

Objectives: Many studies on the relationship between gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) were based on symptoms, but there are few research on it using reflux monitoring. This study was designed to investigate the relationship between GERD and LPR based on pH monitoring. Methods: All patients were scheduled for esophageal manometry and pH monitoring sequentially. They were stratified into 4 groups as no reflux disease, isolated GERD, isolated LPR (iLPR), and GERD combined with LPR (GERD&LPR) according to pH monitoring. Results: The incidence of LPR in GERD was 46.3%, while the probability of combining GERD in LPR was 52.7%. The reflux profile in the laryngopharynx showed a significant difference in the total reflux time (17.82 ± 18.4 vs 9.62 ± 9.58, P = .023) and the percentage of total reflux time (1.31% ± 1.37% vs 0.71% ± .0.73%, P = .023) between the GERD&LPR and iLPR groups. Conclusion: Laryngopharyngeal reflux can be combined with GERD or it can exist as an independent diagnosis. In patients with GERD&LPR, the total reflux time and the percentage of reflux time in the laryngopharynx are higher than those in the iLPR group. Reflux episodes in the laryngopharynx of patients with GERD&LPR may be derived from GERD.


2021 ◽  
Vol 10 (22) ◽  
pp. 5262
Author(s):  
Yung-An Tsou ◽  
Sheng-Hwa Chen ◽  
Wen-Chieh Wu ◽  
Ming-Hsui Tsai ◽  
David Bassa ◽  
...  

Laryngopharyngeal reflux disease (LPRD) might be associated with reflux symptoms, and its severity is correlated with the Reflux Symptoms Index. Diagnosis is often challenging because of a lack of accurate diagnostic tools. Although an association between LPRD and gastroesophageal reflux disease (GERD) exists, the extent to which esophageal pressure changes in patients with LPRD with GERD has been unknown. Therefore, this study surveys the clinical assessments and extent of esophageal pressure changes in LRPD patients with various GERD severities, and compares esophageal sphincter pressures between ages, genders, and body mass index (BMI). This observational study assessed patients with LPRD and GERD. High-resolution esophageal manometry was used to gather data pertaining to the area pressure on the upper esophageal sphincter (UES) and lower esophageal sphincter (LES), and the correlation between such pressure and symptom severity was determined. We compared the esophageal pressure of different UES and LES levels in the following categories: gender, age, BMI, and GERD severity. We analyzed correlations between esophageal pressure and clinical assessments among 90 patients with throat globus with laryngitis with LPRD. LPRD was measured using laryngoscopy, and GERD was measured using esophagoscopy and 24 h PH monitoring. There were no significant differences in the clinical assessments among the four grades of GERD. The LPRD patients with serious GERD had a lower UES and LES pressure. The lowest pressure and longer duration of LES and UES were also observed among patients with LPRD of grade D GERD. No significant differences in UES and LES pressures among ages, genders, or BMIs were noted.


2021 ◽  
pp. 000313482199868
Author(s):  
Fernando A. M. Herbella ◽  
Marco G. Patti

Idiopathic pulmonary fibrosis (IPF) and gastroesophageal reflux disease (GERD) are undoubtedly related. Even though it is not clear yet which one is the primary disease, they certainly interact increasing each other’s severity. Symptoms are unreliable to diagnose GERD in patients with IPF, and objective evaluation with pH monitoring and/or bronchoalveolar lavage analysis is mandatory. Pharmacological treatment with proton pump inhibitors (PPIs) may bring control of IPF in few patients, but PPIs do not control reflux but just change the pH of the gastric refluxate. Surgical therapy based on a fundoplication is safe and effective as it controls any type of reflux, independently from the pH of the gastric refluxate. In patients waiting for lung transplantation (if they can tolerate a laparoscopic operation under general anesthesia), a fundoplication before the operation might block the progression of IPF, while after transplantation it might prevent rejection by preventing the bronchiolitis obliterans syndrome.


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