Patterns of laryngopharyngeal and gastroesophageal reflux

2009 ◽  
Vol 123 (S31) ◽  
pp. 42-47 ◽  
Author(s):  
K Sato ◽  
H Umeno ◽  
S Chitose ◽  
T Nakashima
Keyword(s):  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Gold Standard ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Lower Oesophageal Sphincter ◽  
Percentage Time ◽  
Laryngopharyngeal Reflux Disease ◽  
Time Periods ◽  
Ph Level

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.

scholarly journals A Comparison between W score and Ryan score in diagnosing of Laryngopharyngeal reflux disease

2021 ◽  
Author(s):  
Gang Wang ◽  
Lei Wang ◽  
Zhezhe Sun ◽  
Yuzhu Guo ◽  
Hongdan Liu ◽  
...  
Keyword(s):  
Reflux Disease ◽  
Predictive Value ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Normal Population ◽  
Neck Surgery ◽  
Diagnostic Value ◽  
Diagnostic Sensitivity ◽  
Clinical Trial Registry ◽  
Laryngopharyngeal Reflux Disease

Abstract ObjectiveTo assess the diagnostic value of W score which was supposed to identify laryngopharyngeal reflux disease (LPRD) patients from the normal population by Dx-pH monitoring, comparing with Ryan score.MethodsOne hundred and eight patients with suspected LPRD and complete follow-up results after more than 8 weeks of anti-reflux therapy were enrolled from the Department of Otolaryngology-Head and Neck Surgery, Gastroenterology and Respiratory Medicine of seven hospitals. Their Dx-pH monitoring data before treatment were reanalyzed to obtain the W score besides Ryan score and then the diagnostic sensitivity and specificity were compared according to the result of anti-reflux therapy.ResultsEighty-seven (80.6%) cases were anti-reflux therapy effective, and 21 patients (19.4%) were ineffective. Twenty-seven patients (25.0%) had a positive Ryan score. The W score was positive in 79 (73.1%) patients. There were 52 patients who had a negative Ryan score, but a positive W score. The diagnostic sensitivity, specificity, positive predictive value and negative predictive value of the Ryan score were 28.7%, 90.5%, 92.6% and 23.5%, respectively (kappa = 0.092, p = 0.068), whereas those of the W score for LPRD were 83.9%, 71.4%, 92.4% and 51.7%, respectively (kappa = 0.484, p < 0.001).ConclusionsW score is much more sensitive for the diagnosis of LPRD. Prospective studies with larger patient populations are necessary to validate and improve the new diagnostic criteria.Trial RegistrationChinese Clinical Trial Registry: ChiCTR1800014931.

scholarly journals The Relationship Between Gastroesophageal Reflux Disease and Laryngopharyngeal Reflux Based on pH Monitoring

2020 ◽  
pp. 014556132097191
Author(s):  
Yun Wu ◽  
Junyao Wang ◽  
Qing Huang ◽  
Tao Peng ◽  
Lili Zhao ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Esophageal Manometry ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Reflux Time ◽  
Total Reflux ◽  
Significant Difference ◽  
The Relationship

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.

scholarly journals Pendekatan Diagnostik Refluks Laring Faring

e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 457
Author(s):  
Karin I. Rompas ◽  
Steward K. Mengko ◽  
Ora Et Labora I. Palandeng
Keyword(s):  
Literature Review ◽  
Symptom Score ◽  
Reflux Disease ◽  
Fiber Optic ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Lifestyle Changes ◽  
Reflux Symptom ◽  
Laryngopharyngeal Reflux Disease ◽  
And Behavior

Abstract: Lifestyle and behavior changes can have bad impacts on our health. One of the diseases that can be caused by lifestyle changes is pharyngeal larynx reflux. Pharyngeal laryngeal reflux is a state of return of the contents of the stomach to the larynx and pharynx causing an inflammatory reaction to the mucous membranes of the larynx and pharynx. In an attempt to diagnose pharyngeal larynx reflux, a follow-up examination is required. In this case there are several examinations that can be done to confirm the diagnosis of pharyngeal larynx reflux. This study was aimed to obtain the diagnostic approaches in laringopharyngeal reflux cases. This was a literature review study using two databases namely PubMed and ClinicalKey. The keywords used were laringophaingeal reflux and laryngopharyngeal reflux disease. After being selected based on inclusion and exclusion criteria, nine literatures using experimental research methods. were obtained. The results showed that several examinations that could be performed in diagnosing laringofaringeal reflux, as follows: anamnesis, physical examination, pH-monitoring, reflux findings score, reflux symptom score, PEP-test, reflux sign assessment, reflux symptom score, immunohistochemistry, and fiber-optic laryngoscopy. In conclusion, supporting examinations are needed to confirm the diagnosis of pharyngeal larynx reflux.Keywords: refluks laring faring; laryngopharyngeal reflux disease. Abstrak: Perubahan gaya hidup dan perilaku dapat berdampak pada kesehatan tubuh. Salah satu penyakit yang dapat diakibatkan oleh perubahan gaya hidup yaitu refluks laring faring. Refluks laring faring merupakan keadaan kembalinya isi lambung ke laring dan faring sehingga menyebabkan reaksi inflamasi pada selaput lendir laring dan faring. Untuk menegakkan diagnosis refluks laring faring dibutuhkan pemeriksaan lanjutan. Penelitian ini bertujuan untuk mengetahui pendekatan diagnosis yang dapat dilakukan dalam pemeriksaan kasus refluks laring faring. Jenis penelitian ialah literature review dengan pencarian data menggunakan dua database yaitu PubMed dan ClinicalKey. Kata kunci yang digunakan yaitu refluks laring faring and laryngopharyngeal reflux disease. Setelah diseleksi berdasarkan kriteria inklusi dan eksklusi, didapatkan sembilan literatur yang menggunakan metode penelitian eksperimental. Hasil peneli-tian mendapatkan pemeriksaan-pemeriksaan yang dilakukan dalam menegakkan diagnosis refluks laring faring ialah: anamnesis, pemeriksaan fisik, pH-monitoring, skor temuan refluks, skor gejala refluks, PEP-test, reflux sign assessment, reflux symptom score, immunohistochemistry, dan fiber-optic laryngoscopy. Simpulan penelitian ini ialah pemeriksaan penunjang perlu dilakukan untuk menegakkan diagnosis refluks laring faring.Kata kunci: refluks laring faring; laryngopharyngeal reflux disease

Gastroesophageal reflux/laryngopharyngeal reflux disease: a critical analysis of the literature

2009 ◽  
Vol 267 (2) ◽  
pp. 171-179 ◽  
Author(s):  
M. N. Kotby ◽  
O. Hassan ◽  
Aly M. N. El-Makhzangy ◽  
M. Farahat ◽  
M. Shadi ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Critical Analysis ◽  
Laryngopharyngeal Reflux ◽  
Laryngopharyngeal Reflux Disease

scholarly journals What Is Nonacid Reflux Disease?

2011 ◽  
Vol 25 (1) ◽  
pp. 35-38 ◽  
Author(s):  
Martin A Storr
Keyword(s):  
Clinical Practice ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Gold Standard ◽  
Standard Treatment ◽  
Ph Monitoring ◽  
Nonacid Reflux ◽  
Impedance Monitoring ◽  
Esophageal Sphincter

Proton pump inhibitors (PPIs) are the gold standard treatment for gastroesophageal reflux disease. In clinical practice, failure of PPIs occurs frequently, and may affect up to 30% of patients in a typical gastroenterology practice. Multichannel impedance monitoring combined with pH monitoring helps to detect nonacid reflux, and if symptoms correlate with these nonacid reflux episodes, nonacid reflux disease can be diagnosed. In contrast to PPIs, reflux inhibitors target transient lower esophageal sphincter relaxations, which are involved in the pathophysiology of reflux disease and may be the appropriate future treatment for nonacid reflux disease. The present article discusses the current understanding of nonacid reflux disease, its diagnosis and treatment.

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