Facts and Fantasies on Extraesophageal Reflux

2017 ◽  
Vol 51 (9) ◽  
pp. 769-776 ◽  
Author(s):  
Frank Zerbib ◽  
Charlotte Dulery
Keyword(s):  
Extraesophageal Reflux

302 Esophageal Mucosal Impedance Pattern Is Distinct in Patients With Extraesophageal Reflux Symptoms

2015 ◽  
Vol 148 (4) ◽  
pp. S-66
Author(s):  
Robert T. Kavitt ◽  
Elif Saritas Yuksel ◽  
Fehmi Ates ◽  
James C. Slaughter ◽  
Tina Higginbotham ◽  
...  
Keyword(s):  
Extraesophageal Reflux ◽  
Reflux Symptoms

Prevalencia de mucosa gástrica heterotópica cervical y su relación con síntomas de reflujo gastroesofágico. Estudio observacional

2021 ◽  
Vol 51 (2) ◽  
Author(s):  
Natalia Marina Zeytuntsian ◽  
José Tawil ◽  
Ana Adet Caldelari ◽  
Álvaro Falzone ◽  
Patricio Sheridan ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Clinical Manifestations ◽  
Heterotopic Gastric Mucosa ◽  
Extraesophageal Reflux ◽  
Cross Sectional ◽  
Reflux Symptoms ◽  
Throat Clearing ◽  
Extraesophageal Symptoms ◽  
The Mean ◽  
Upper Gastrointestinal

Introduction. The heterotopic gastric mucosal patch or inlet patch is the presence of gastric columnar mucosa outside the stomach, most frequently located in the proximal esophagus. Its manifestations vary from esophageal and extraesophageal reflux symptoms to major complications, most of them being asymptomatic. Aim. To determine the prevalence of cervical heterotopic gastric mucosa in our environment and its association with esophageal and extraesophageal reflux symptoms. Material and methods. Prospective cross-sectional and observational study; consecutive patients who came to our institution between December 2018 and October 2019 for diagnostic upper gastrointestinal videoendoscopy were included, following a questionnaire on clinical manifestations. Results. A total of 1,408 patients were included. In 89 (6.3%), a cervical heterotopic gastric mucosal patch was described. The mean age of the patients without this condition was 54.6 and 55.5 in patients with it. The esophageal symptoms of gastroesophageal reflux (heartburn, regurgitation, and chest pain) in patients with cervical heterotopic gastric mucosa was observed in 40 (44.9% / p = 0.473), 12 (13.5% / p = 0.783) and 4 (4.5% / p = 0.199) patients respectively. The presence of extraesophageal symptoms (globus, chronic cough, dysphonia, and throat clearing) in patients with cervical heterotopic gastric mucosa was: 9 (10.1% / p = 0.011); 7 (7.9% / p = 0.155); 4 (4.5% / p = 0.458) and 9 (10.1% / p = 0.036) respectively. Conclusions. A statistically significant association was found between the presence of cervical heterotopic gastric mucosal patch and symptoms of globus (p = 0.011) and throat clearing (p = 0.036). It could be interpreted that this group of patients would benefit from the research and treatment of this condition with the intention of improving their symptoms.

scholarly journals Gastroesophageal Reflux and Idiopathic Pulmonary Fibrosis: A Prospective Study

Medicina ◽  
2011 ◽  
Vol 47 (4) ◽  
pp. 28 ◽  
Author(s):  
Ahmed Fahim ◽  
Peter Dettmar ◽  
Alyn Morice ◽  
Simon Hart
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Gastroesophageal Reflux ◽  
Prospective Study ◽  
Antibody Detection ◽  
Extraesophageal Reflux ◽  
Reflux Symptoms ◽  
Significant Difference ◽  
H Pylori ◽  
A Prospective Study

Background and Objective. Idiopathic pulmonary fibrosis (IPF) is the most common of the idiopathic interstitial pneumonias. There is evidence of the increased prevalence of gastroesophageal reflux disease in patients with IPF. The aim of this prospective study was to evaluate reflux in patients with IPF by analyzing the scores of the reflux cough questionnaire, measurement of pepsin in exhaled breath condensate (EBC) to detect extraesophageal reflux, and Helicobacter pylori serology to evaluate the prevalence of this stomach bacterium in patients with IPF. Material and Methods. The Hull airway reflux questionnaire (HARQ) was completed by 40 patients with IPF and 50 controls in order to evaluate reflux symptoms. EBC was collected from 23 patients (17 patients with IPF and 6 controls) for measurement of pepsin by the lateral flow technique. A prospective study of 57 subjects (34 patients with IPF and 23 controls) for H. pylori antibody detection by ELISA was performed. Results. Significantly higher HARQ scores (maximum score, 70) were recorded in patients with IPF compared with controls (19.6 [SD, 12.4] vs. 3 [SD, 2.9], P<0.001). There was no significant difference in EBC pepsin positivity between patients with IPF and controls (2 of the 17 patients vs. none of the 6 controls, P=0.38). There was no significant difference in H. pylori serology between patients with IPF and controls (17 of the 34 patients vs. 14 of the 23 controls, P=0.42). Conclusion. Patients with IPF had significantly increased scores of airway reflux symptoms. However, no objective evidence of extraesophageal reflux or H. pylori infection in patients with IPF was obtained in this study. The role of gastroesophageal and extraesophageal reflux in pathogenesis of IPF should be evaluated in a larger prospective study.

Immunologic Response of the Laryngeal Mucosa to Extraesophageal Reflux

2008 ◽  
Vol 117 (12) ◽  
pp. 891-895 ◽  
Author(s):  
Martin A. Birchall ◽  
Michael Bailey ◽  
Danuta Gutowska-Owsiak ◽  
Nikki Johnston ◽  
Charlotte F. Inman ◽  
...  
Keyword(s):  
Major Histocompatibility Complex ◽  
Laryngopharyngeal Reflux ◽  
Mucosal Immune Response ◽  
Extraesophageal Reflux ◽  
Major Histocompatibility ◽  
Nkt Cell ◽  
Histocompatibility Complex ◽  
Laryngeal Mucosa ◽  
A Prospective Study ◽  
Antigen Presenting

Objectives: Extraesophageal reflux is common. The treatment costs are high, and there are associations with other diseases, including laryngeal cancer. Our studies of the mucosal immune response to this common inflammatory disease suggest an important role for the nonclassic antigen-presenting molecule CD1d in the response to inflammation. This study was performed to further explore the relationship between the CD1d–NKT cell–iGb3 axis and reflux. Methods: We carried out a prospective study of laryngeal biopsies from 12 patients with laryngopharyngeal reflux and 11 controls. Quantitative multiple-color immunofluorescence using antibodies for lymphocytes (CD3, CD161) and classic and nonclassic major histocompatibility complex (I, II, β2m, CD1d) was performed, and univariate and multivariate analysis and co-localization measurements were applied. Results: Epithelial major histocompatibility complex class I and II expression was unchanged by reflux, but expression of CD1d increased (p < 0.05; luminal layers) and confidence intervals diminished in the reflux group. Co-localization of NKT cells with CD1d increased in patients (p < 0.01); iGb3 exhibited strong expression throughout all layers of the laryngeal epithelium. Conclusions: These data indicate a role for the CD1d–NKT cell–iGb3 axis in response to extraesophageal reflux in humans. This represents a useful target for novel diagnostics and treatments for this common condition.

A Comparison of Rating Scales Used in the Diagnosis of Extraesophageal Reflux

2011 ◽  
Vol 25 (3) ◽  
pp. 293-300 ◽  
Author(s):  
Joy Musser ◽  
Lisa Kelchner ◽  
Jean Neils-Strunjas ◽  
Marshall Montrose
Keyword(s):  
Rating Scales ◽  
Extraesophageal Reflux

scholarly journals Esophageal Impedance-pH Monitoring and Pharyngeal pH Monitoring in the Diagnosis of Extraesophageal Reflux in Children

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Anna Plocek ◽  
Beata Gębora-Kowalska ◽  
Jakub Białek ◽  
Wojciech Fendler ◽  
Ewa Toporowska-Kowalska
Keyword(s):  
Clinical Symptoms ◽  
Ph Monitoring ◽  
Acid Reflux ◽  
Extraesophageal Reflux ◽  
Bolus Transit ◽  
Impedance Probe ◽  
Ph Decrease ◽  
Ph Level ◽  
Esophageal Impedance ◽  
Multichannel Intraluminal Impedance Ph

Various clinical symptoms are attributed to extraesophageal reflux disease (EERD). Multichannel intraluminal impedance-pH monitoring (MII-pH) is considered to correlate symptoms with acid and nonacid gastroesophageal reflux (GER) events. Pharyngeal pH monitoring (Dx-pH) is considered to correlate the decrease in the pH level in the oropharynx with reported symptoms and to diagnose supraesophageal reflux. We aimed to assess the correlation between acid reflux episodes recorded by Dx-pH and GER detected via MII-pH in children with suspected EERD. The study enrolled 23 consecutive children (15 boys and 8 girls; median age 8.25 [range 3-16.5] years) with suspected EERD. MII-pH and Dx-pH were conducted concurrently in all patients. A total of 1228 reflux episodes were recorded by MII-pH. With the antimonic sensor placed inside the impedance probe, 1272 pH-only reflux episodes were recorded. Of these, 977 (76.81%) were associated with a retrograde bolus transit. Regarding GER, 630 full-column episodes extended to the most proximal pair of impedance sensors; 500 (83.33%) demonstrated an acidic character. The following acid reflux numbers were determined by the Dx-pH system: forpH<4,n=126;pH<4.5,n=136;pH<5,n=167; andpH<5.5,n=304, and for a decrease inpH>10%relative to the baseline,n=324. There was no significant correlation between the number of pharyngeal reflux episodes detected by Dx-pH and that of GERs identified by MII-pH. The proportion of oropharyngeal pH events that were temporally related to a GER episode increased with the extended pH criteria. The highest proportion was observed for a pH decrease of ≥10% from the baseline and did not exceed 5.2%. The application of the extended pH criteria in the Dx-pH system resulted in an increase in the number of diagnosed laryngopharyngeal refluxes; most were not temporally associated with GER episodes confirmed by MII-pH. Thus, the efficacy of the exclusive application of Dx-pH for supraesophageal gastric reflux diagnosis is uncertain.

Acute Histologic Effects of Extraesophageal Reflux on Vocal Fold Healing

2005 ◽  
Vol 114 (4) ◽  
pp. 296-303 ◽  
Author(s):  
Seth M. Cohen ◽  
C. Gaelyn Garrett ◽  
Shan Huang ◽  
Mark S. Courey
Keyword(s):  
Wound Healing ◽  
Analysis Of Variance ◽  
Vocal Fold ◽  
Saline Solution ◽  
Vocal Folds ◽  
Canine Model ◽  
Extraesophageal Reflux ◽  
Cellular Infiltrate ◽  
Acute Wound ◽  
Hematoxylin And Eosin

This study evaluates how extraesophageal reflux affects membranous vocal fold healing in a canine model. We created membranous vocal fold injuries in the animals and randomly assigned them to topical application of acid and pepsin at pH 2 or pH 6 or of normal saline solution every other day for 12 days. The experimental vocal folds were compared to uninjured, control vocal folds from animals painlessly sacrificed for other reasons. Hematoxylin and eosin, fibronectin, and procollagen I staining were performed for histologic analysis. The injured specimens had three times greater cellular infiltrate (p ≤ .001, analysis of variance) and twice as much fibronectin and procollagen I (p ≤ .001, analysis of variance) as did the specimens from the control animals. No significant differences or trends were identified for cellular infiltrate, fibronectin, or procollagen I within the injured groups (p > .05, Bonferroni t-test). Acute wound healing did not appear to be influenced by the presence of acid and pepsin at pH 2 or 6 as compared to saline solution.

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