The Association between Helicobacter Pylori and Laryngopharyngeal Reflux in Laryngeal Pathologies

We conducted a study to determine the presence or absence of Helicobacter pylori and laryngopharyngeal reflux (LPR) in 43 previously untreated patients who had presented with a laryngeal lesion. Our aim was to determine if there was any association among H pylori, LPR, and laryngeal lesions. H pylori status was determined by real-time polymerase chain reaction (PCR) assays of biopsy tissue obtained during direct laryngoscopy. The presence or absence of LPR was determined on the basis of patients’ reflux symptom index (RSI) and reflux finding score (RFS), which were based on their questionnaire responses and findings on endoscopic examination of the larynx, respectively. Patients with an RSI of 14 or more and/or an RFS of 8 or more were considered to have LPR. H pylori was present in 24 patients (55.8%) and absent in 19 (44.2%)—not a statistically significant difference. The prevalence of LPR was higher than the prevalence of H pylori; it was present in 30 patients (69.8%) and absent in 13 (30.2%). The difference was statistically significant (p = 0.01). We found no association between H pylori status and LPR status. Additionally, we analyzed two subgroups based on whether their lesions were benign or malignant/premalignant and found a significant relationship between LPR positivity and the presence of malignant/premalignant laryngeal lesions (p = 0.03). We found no association between H pylori status and either of the two subgroup categories.

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The Effect of Gastric Helicobacter pylori Colonization on Nasal Functions

Ear Nose & Throat Journal ◽

10.1177/0145561319840825 ◽

2019 ◽

Vol 98 (6) ◽

pp. 346-350 ◽

Cited By ~ 1

Author(s):

Tolgar Lütfi Kumral ◽

Yasemin Gökden ◽

Ziya Saltürk ◽

Güler Berkiten ◽

Güven Yıldırım ◽

...

Keyword(s):

Helicobacter Pylori ◽

Laryngopharyngeal Reflux ◽

Test Results ◽

Reflux Symptom Index ◽

Symptom Index ◽

Olfactory Test ◽

Sinonasal Outcome Test ◽

H Pylori ◽

Nasal Function ◽

Snot 22

The aim of this study is to investigate the effect of gastric Helicobacter pylori colonization on nasal functions. The study enrolled patients (n = 100) who underwent endoscopy for gastroesophageal reflux disease. Patients with laryngopharyngeal reflux (LPR) were identified by Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). Patients were divided into 2 groups: LPR (+) (n = 64) H pylori (+), RSI > 13, RFS > 7; LPR (−) (n = 36) H pylori (+), RSI < 13, RFS < 7. Visual analog scale (VAS), sinonasal outcome test-22 (SNOT-22), peak nasal inspiratory flowmeter (PNIF), mucociliary clearance (MCC), and olfactory tests were used to evaluate the nasal functions. The average VAS for nasal obstruction, PNIF, and MCC did not differ significantly between the LPR (+) and LPR (−) groups ( P > .05). However, the average olfactory test scores were lower in the LPR (+) patients than the LPR (−) patients ( P < .05). Also, the SNOT-22 scores were significantly higher in LPR (+) patients than in LPR (−) ( P < .01). Nasal functions and symptom scores were also evaluated according to the H pylori grading. The PNIF, MCC, SNOT-22, and olfactory test results deteriorated as the gastric mucosal H pylori colonization increased ( P < .05). In conclusion, nasal functions differed between LPR disease and GERD only, while the density of H pylori colonization in the gastric mucosa had an effect on nasal function.

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The evaluation of nasal mucociliary clearance in patients with Helicobacter pylori infection

The Journal of Laryngology & Otology ◽

10.1017/s0022215119000136 ◽

2019 ◽

Vol 133 (03) ◽

pp. 220-223

Author(s):

S Üstün Bezgin ◽

T Çakabay ◽

K Irak ◽

M Koçyiğit ◽

B Serin Keskineğe ◽

...

Keyword(s):

Helicobacter Pylori ◽

Mucociliary Clearance ◽

Endoscopic Examination ◽

Control Group ◽

Clearance Time ◽

Saccharine Test ◽

Significant Difference ◽

And Gender ◽

H Pylori ◽

Nasal Mucociliary Clearance

AbstractObjectiveThis study aimed to examine nasal mucociliary clearance time in patients with Helicobacter pylori infection.MethodsFifty patients who were newly diagnosed with H pylori infection using gastric biopsy in the gastroenterology out-patient clinic, and 50 age- and gender-matched healthy adults who were admitted to the otorhinolaryngology out-patient clinic, were included in this study. After an otorhinolaryngological examination (anterior rhinoscopy and nasal endoscopic examination), the nasal mucociliary clearance time of each subject was calculated using the saccharine test.ResultsThe mean mucociliary clearance time was 06:29 ± 3:31 minutes (range, 00:55–15:19 minutes) in the control group and 10:12 ± 06:09 minutes (range, 01:28–32:00 minutes) in the study group. Comparisons of the two groups revealed a statistically significant difference (p = 0.002).ConclusionNasal mucociliary clearance time was significantly increased in patients with H pylori infection. The results suggest that H pylori infection may have an unfavourable effect on nasal mucociliary clearance.

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The Value of Routine pH Monitoring in the Diagnosis and Treatment of Laryngopharyngeal Reflux

Otolaryngology ◽

10.1177/0194599812436952 ◽

2012 ◽

Vol 146 (6) ◽

pp. 952-958 ◽

Cited By ~ 24

Author(s):

Michael Friedman ◽

Craig Hamilton ◽

Christian G. Samuelson ◽

Kanwar Kelley ◽

Renwick Taylor ◽

...

Keyword(s):

Predictive Value ◽

Laryngopharyngeal Reflux ◽

Ph Monitoring ◽

Linear Regression Analysis ◽

Tertiary Care ◽

Case Series ◽

Reflux Symptom ◽

Reflux Symptom Index ◽

Symptom Index ◽

Significant Difference

Objective. To assess the need for pH testing in diagnosing laryngopharyngeal reflux (LPR). Study Design. Case series with planned data collection. Setting. Tertiary care center. Subjects and Methods. On the basis of symptoms and/or abnormal endoscopic findings, more than 500 patients underwent 24-hour pharyngeal pH testing at a single center (using the Dx-pH probe) between January 2009 and June 2011. A total of 163 patients not on proton-pump inhibitors at the time of study and with complete data available for analysis (pH results, body mass index, smoking status, pretest reflux symptom index) were divided into 2 groups by positive (n = 70) and negative (n = 93) Ryan Score. The Reflux Symptom Index (RSI) was compared between groups and assessed overall against Ryan Score parameters at different pH thresholds. The diagnostic utility of an RSI ≥ 13 for prediction of Ryan Score was assessed. Results. No significant difference in RSI was seen between Ryan-positive (17.50 ± 11.47) and Ryan-negative (14.95 ± 11.43) patients ( P = .161). Overall, RSI correlated poorly with percentage time spent below pH thresholds 6.5, 6.0, 5.5, and 5.0 and upright and supine Ryan parameters at these thresholds (as determined by linear regression analysis). The sensitivity, specificity, positive predictive value, and negative predictive value of RSI ≥ 13 for Ryan positivity were 55.7%, 47.3%, 44.3%, and 58.7%, respectively. Conclusion. Our findings show that in our population of otolaryngology patients, the diagnosis of LPR cannot be reliably made on the basis of symptoms alone. Diagnosis, and in particular treatment decisions, should ideally be made on the basis of a combination of symptoms, signs, and confirmatory testing.

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Gastric mucosa-associated lymphoid tissue lymphoma in conjunction with multiple lymphomatous polyposis in the context of Helicobacter pylori and Helicobacter suis superinfection

Clinical Journal of Gastroenterology ◽

10.1007/s12328-020-01310-5 ◽

2021 ◽

Author(s):

Toshikatsu Naito ◽

Ryo Yuge ◽

Shinji Tanaka ◽

Rina Otani ◽

Hiroki Kadota ◽

...

Keyword(s):

Helicobacter Pylori ◽

Malt Lymphoma ◽

Lymphoid Tissue ◽

Histopathological Examination ◽

Endoscopic Examination ◽

Gastric Body ◽

Gastric Malt Lymphoma ◽

Polymerase Chain ◽

Multiple Lymphomatous Polyposis ◽

H Pylori

AbstractA 53-year-old woman visited a doctor and complained of chest discomfort after meals. Esophagogastroduodenoscopy showed multiple granular elevations in the gastric body. After biopsies from the elevations, she was diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma. Polymerase chain reaction also detected Helicobacter pylori and H. suis. Treatment to eradicate H. pylori and H. suis was successful. Endoscopic examination after the bacterial eradication treatment showed that multiple granular elevations remained in the gastric body; however, no lymphoma cells were found during histopathological examination. Thus, we reported a case of H. pylori-positive gastric MALT lymphoma with a unique morphology associated with H. suis superinfection.

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Results of the study of conservative treatment of laryngeal manifestations of laryngopharyngeal reflux

Medical Council ◽

10.21518/2079-701x-2021-18-28-33 ◽

2021 ◽

pp. 28-33

Author(s):

I. B. Angotoeva ◽

M. M. Magomedova

Keyword(s):

Laryngopharyngeal Reflux ◽

Stomach Contents ◽

Reflux Symptom Index ◽

Symptom Index ◽

Results Of Treatment ◽

Functional Dysphonia ◽

Significant Difference ◽

Reflux Laryngitis ◽

Extraesophageal Symptoms ◽

Antireflux Therapy

Gastroesophageal reflux disease (GERD) is a disease of the gastrointestinal tract caused by the discharge of stomach contents into the esophagus. In GERD, both esophageal and extraesophageal manifestations are widespread, but, unfortunately, the latter are less well known. About one third of GERD patients have extraesophageal symptoms, which can occur even in the absence of the usual esophageal symptoms of GERD, which makes diagnosis difficult. The most common of these is laryngitis. In addition to reflux laryngitis, laryngopharyngeal reflux (LFR) can cause the development of contact granulomas, laryngeal stenosis, functional dysphonia, vocal fold nodules, Reinecke's edema, and laryngeal neoplasms. These symptoms disappear after taking antireflux therapy, but there is still no consensus on its duration.Aim. To evaluate the results of treatment of laryngeal manifestations of LFR with omeprasole 20 mg 30 minutes before meals in the morning.Methods. The study involved 531 patients with complaints of hoarseness, of which women 337 - 63.5%, men 194 - 36.5%. We prescribed omeprasole 20 mg 30 minutes before meals in the morning for 6 weeks. Patients were questioned using the Reflux Symptom Index (RSI) questionnaire and indirect laryngoscopy with an assessment of laryngeal changes according to the Reflux Signs Scale (RSS).Results. There was a statistically significant decrease in hoarseness 1 week after treatment, which continues to decrease 6 weeks after the initiation of treatment when evaluating the data on the RSI questionnaire. There was no statistically significant difference in the laryngoscopic picture before the start of treatment and after 1 week of treatment according to RSS; a statistically significant decrease in the quantitative assessment of RSS was revealed 6 weeks after the initiation of treatment.Conclusions. Omeprasole at a dose of 20 mg in 30 minutes reduces the symptoms of LFR already after 1 week, the decrease in the severity of symptoms continues by 6 weeks of its use. Improvement of the laryngoscopic picture with the appointment of omeprazole 20 mg 30 minutes before meals occurs by the 6th week of its use. A positive correlation was found between the severity of LFR symptoms, including hoarseness, and the severity of changes in the laryngoscopic picture.

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Impact of Nissen Fundoplication on Laryngopharyngeal Reflux Symptoms

The American Surgeon ◽

10.1177/000313481107700723 ◽

2011 ◽

Vol 77 (7) ◽

pp. 878-882 ◽

Cited By ~ 9

Author(s):

Lionel Van Der Westhuizen ◽

Stephen J. Von ◽

Brent J. Wilkerson ◽

Brent L. Johnson ◽

Yonge Jones ◽

...

Keyword(s):

Surgical Intervention ◽

Nissen Fundoplication ◽

Laryngopharyngeal Reflux ◽

Symptom Improvement ◽

Adult Onset ◽

Reflux Symptom Index ◽

Symptom Index ◽

Throat Clearing ◽

Significant Difference ◽

Successful Group

The reliability of Nissen fundoplication for the successful treatment of laryngopharyngeal reflux (LPR) symptoms remains in question. The purpose of this study was to assess the effect that antireflux surgery has on a variety of LPR symptoms as well as the patient's perceived success of surgical intervention. A retrospective review of all antireflux surgeries between 1998 and 2008 provided a patient base for a survey in which patients ranked pre- and postoperative LPR symptoms in addition to patient satisfaction with the outcome. Of the 611 patients identified and sent the evaluation forms, 244 responses (40%) were obtained. The percentage of patients with symptom improvement after surgery were: heartburn (90.1%), regurgitation (92.6%), voice fatigue (75.2%), chronic cough (76.3%), choking episodes (83.1%), sore throat (82.9%), lump in throat (77.4%), repetitive throat clearing (72.8%), and adult-onset asthma (59.6%). Twenty per cent with repetitive throat clearing and 30 per cent with adult-onset asthma had no improvement in symptoms. Eighty-one per cent considered surgery to be a success. Comparison of those who claimed the operation was successful with those who claimed it was not revealed no difference in demographics, primary diagnosis, procedure type, or reflux symptom index score. There was a statistically significant difference in patient-perceived outcome according to the length of time since surgery. More than 88 per cent in the “not successful” group had an operation greater than 4 years prior as compared with only 70 per cent in the “successful” group ( P = 0.020). Nissen fundoplication is an effective treatment for most LPR symptoms, although patients with adult-onset asthma and repetitive throat clearing appear to benefit least from surgical intervention.

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A Prospective Randomized Clinical Trial of Combination Therapy with Proton Pump Inhibitors and Mucolytics in Patients with Laryngopharyngeal Reflux

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420913592 ◽

2020 ◽

Vol 129 (8) ◽

pp. 781-787

Author(s):

Minsuk Chae ◽

Dong Hyuk Jang ◽

Ho Chan Kim ◽

Minsu Kwon

Keyword(s):

Combination Therapy ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Laryngopharyngeal Reflux ◽

Symptomatic Relief ◽

Control Group ◽

Reflux Symptom Index ◽

Symptom Index ◽

Significant Difference

Objectives: To identify whether combination therapy with mucolytics and proton pump inhibitors (PPIs) leads to faster and more effective symptomatic relief in patients with laryngopharyngeal reflux (LPR). Methods: Patients diagnosed as LPR with a reflux symptom index (RSI) ≥ 13 and a reflux finding score (RFS) ≥ 7 were enrolled in this prospective study. Patients were randomly allocated to control (PPI only) or experimental (PPI + mucolytics) groups and changes in RSI and RFS values were assessed at 1- and 3-month follow-up. Results: One hundred sixteen patients were randomly allocated into either the control group ( n = 59) or the experimental group ( n = 57). The RSI and RFS scores significantly decreased in both groups (all P < .001) after 1 month of treatment; however, there was no significant difference in RSI change between groups ( P = .223). After 3 months of treatment, there remained no significant difference in RSI change between groups ( P = .592). Conclusions: Combination therapy with mucolytics and PPI compared to PPI alone did not lead to faster or more effective symptomatic relief in LPR patients.

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Association of Nasopharyngeal and Laryngopharyngeal Reflux with Postnasal Drip Symptomatology in Patients with and without Rhinosinusitis

American Journal of Rhinology ◽

10.2500/ajr.2006.20.2849 ◽

2006 ◽

Vol 20 (3) ◽

pp. 283-289 ◽

Cited By ~ 37

Author(s):

Sarah K. Wise ◽

Justin C. Wise ◽

John M. DelGaudio

Keyword(s):

Endoscopic Sinus Surgery ◽

Laryngopharyngeal Reflux ◽

Sinus Surgery ◽

Reflux Symptom Index ◽

Symptom Index ◽

Area Index ◽

Postnasal Drip ◽

Objective Evidence ◽

Significant Difference ◽

Reflux Area Index

Background Patients often report postnasal drip (PND), but objective rhinosinusitis and allergy findings are frequently absent. In this study, we evaluate the association between PND and pharyngeal reflux. Methods Sixty-eight participants underwent 24-hour pH testing, including chronic rhinosinusitis (CRS) patients persistently symptomatic after endoscopic sinus surgery, CRS patients successfully treated by endoscopic sinus surgery, and volunteers without a CRS history. The pH probes contained nasopharyngeal (NP), laryngopharyngeal (LP), and distal esophageal sensors. Participants completed the Sinonasal Outcome Test-20 (SNOT-20) and Modified Reflux Symptom Index (MRSI) questionnaires. Survey items addressing PND symptomatology were compared with NP reflux (NPR) below pH 4 and pH 5 (defined as ≥1 event), and LP reflux (LPR; defined as ≥7 events or reflux area index <6.3). Results Pearson analyses revealed a positive correlation of r = 0.87 between SNOT-20 and MRSI PND items. For NPR < pH 4, no significant difference existed between participants with and without reflux on the SNOT-20 or MRSI (p < 0.05). However, for NPR < pH 5, reflux-positive participants exhibited significantly more PND symptoms on the SNOT-20 (p = 0.030) and the MRSI (p = 0.018) compared with participants without reflux. Finally, participants with LPR had significantly more PND symptomatology on the SNOT-20 (p = 0.010) versus those without LPR. A borderline significant difference existed on the MRSI PND item between participants positive and negative for LPR (p = 0.055). Conclusion Objective evidence of NPR and LPR exists in patients reporting PND. Reflux treatment may reduce PND complaints.

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The Relationship Between Infertility and Infection with Clarithromycin Resistant Strain of Helicobacter Pylori in Iraq

Iraqi Journal of Science ◽

10.24996/ijs.2020.61.8.3 ◽

2020 ◽

pp. 1874-1879

Author(s):

Shiamaa G. Abid ◽

Rana S. Aboud

Keyword(s):

Helicobacter Pylori ◽

Seminal Fluid ◽

Control Group ◽

Control Groups ◽

Significant Difference ◽

Polymerase Chain ◽

H Pylori ◽

And Control ◽

The Relationship ◽

Infertile Patients

The relationship between infertility and Helicobacter pylori infection was investigated; samples from thirty-five infertile patients (aged 20-49 years) were collected from Kamal Al-Samaraei hospital , Baghdad, Iraq during the period from the first of February until April 2018. These patients were compared with 10 apparently fertile individuals who served as a control. The study was carried out to detect the DNA of H.pylori in both serum and seminal fluid of male infertile patients and for the control group by Real-Time Polymerase Chain Reaction (RT-PCR) technique. The results revealed that there was a significant difference (P<0.01) in the detection of DNA of H.pylori between patients and control groups. thereby the percentage level of H.pylori DNA in serum was 80% and in the seminal fluid was 0 %. As a result, we strongly suggest that the infection with H. pylori plays an important role in male infertility.

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Geographic Distribution of The cagA, vacA, iceA, oipA and dupA Genes of Helicobacter Pylori Strains Isolated in China

10.21203/rs.3.rs-136079/v1 ◽

2020 ◽

Author(s):

Zhijing Xue ◽

Hong Yang ◽

Dongxing Su ◽

Xiangfeng Song ◽

Xin Deng ◽

...

Keyword(s):

Helicobacter Pylori ◽

Regional Distribution ◽

Chain Reaction ◽

Geographical Differences ◽

Biopsy Specimens ◽

Geographic Differences ◽

Polymerase Chain ◽

The Difference ◽

H Pylori ◽

Geographical Characteristics

Abstract Background: There were geographical differences in the distribution of Helicobacter pylori (H. pylori) genotypes (cagA, vacA, iceA, oipA and dupA, et al). The population in different regions in China have grant different patterns of gastroduodenal diseases which are associated with these genotypes, but the geographical characteristics of H. pylori genotypes were still unknown. Materials and Methods: Gastric biopsy specimens were obtained from 348 patients from five regions in China. The regional distribution was 89 patients from Shandong, 91 from Guangxi, 57 from Hunan, 58 from Qinghai and 53 from Heilongjiang. DNA extracted from cultured isolates were analyzed by polymerase chain reaction (PCR) to determine the presence of cagA, vacA, iceA, oipA and dupA genotypes.Results: A total of 269 H. pylori isolates were obtained, of which 74 isolates were from Shandong, 78 from Guangxi, 46 from Hunan, 33 from Qinghai and 38 from Heilongjiang. The cagA gene was predominant in all the five regions (e.g. 100% in Hunan, Qinghai and Heilongjiang). The predominant vacA genotypes in the 269 isolates were s1a (88.1%) and m1(72.1%). vacA s1b was not detected in our study. In strains from Guangxi and Hunan, s1c was dominant; in contrast, s1a was dominant in Shandong, Qinghai and Heilongjiang. The prevalence of m1 strains in Heilongjiang (92.1%) was significantly higher (P<0.001) than in Shandong (60.8%) and Qinghai (51.5%). The dominant vacA subtype combination was s1a/m1 (62.8%) and detection of vacA s1a/m1 was significantly high 34 (89.5%) in Heilongjiang strains (P<0.001). The prevalence of iceA alleles in Hunan and Qinghai was much higher than that in the other three regions, and the difference was statistically significant. The oipA-positive strains were more prevalent in Guangxi (100%) and Hunan (100%) than in Qinghai (78.8%) (P<0.001). Conversely, the dupA-positive strains were less than half in Guangxi (15.4%) and Shandong (32.4%), whereas it was 73.9% in Hunan and 81.8% in Qinghai (P<0.001).Conclusions: There are significant geographic differences in the distribution of H. pylori genotypes. These datas may be used to explain the gastroduodenal diseases patterns in different geographic regions of China.

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