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

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.

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

2012 ◽  
Vol 146 (6) ◽  
pp. 952-958 ◽  
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.

Impact of Nissen Fundoplication on Laryngopharyngeal Reflux Symptoms

2011 ◽  
Vol 77 (7) ◽  
pp. 878-882 ◽  
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.

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

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.

scholarly journals The Association between Helicobacter Pylori and Laryngopharyngeal Reflux in Laryngeal Pathologies

2012 ◽  
Vol 91 (3) ◽  
pp. E6-E9 ◽  
Author(s):  
Engin Çekin ◽  
Mustafa Ozyurt ◽  
Evren Erkul ◽  
Koray Ergunay ◽  
Hakan Cincik ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Laryngopharyngeal Reflux ◽  
Endoscopic Examination ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Significant Difference ◽  
Laryngeal Lesions ◽  
Polymerase Chain ◽  
The Difference ◽  
H Pylori

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.

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

2006 ◽  
Vol 20 (3) ◽  
pp. 283-289 ◽  
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.

scholarly journals Cross sectional study of prevalence of LPRD at tertiary care hospital

2019 ◽  
Vol 5 (2) ◽  
pp. 445
Author(s):  
Raghvendra Singh Gaur ◽  
Paromita Patra
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Tertiary Care ◽  
Treatment Protocol ◽  
Stomach Contents ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Cross Sectional

<p class="abstract"><strong>Background:</strong> Reflux means return or regurgitation of fluid. When symptoms arise due to reflux of stomach contents into the pharynx and larynx it is termed as laryngopharyngeal reflux disease (LPRD). GERD and LPRD are two different entities and the management principle of GERD doesn’t apply to LPRD. We designed a cross sectional study to evaluate the prevalence of laryngopharyngeal reflux among the patients visiting the ENT outpatient department over a duration of one year.</p><p class="abstract"><strong>Methods:</strong> Patients presenting with throat and voice symptoms for more than a month were included in the study. The reflux symptom index (RSI) put forward by Belafsky et al was used to assess the symptoms of reflux. A diagnosis of reflux was made if the patient had an RSI score &gt;13.  </p><p class="abstract"><strong>Results:</strong> A total of 2669 patients included in study period, out of which 1316 (49.3%) were males and 1353 (50.7%) were females. Out of the 2669, 1938 (72.6%) patients were found to have a RSI of &gt;13. Out of the 1938 patients subjected to 70 laryngoscopy 1842 patients (95%) were found to have a RFS &gt;7. Of the 1842 patients with RFS &gt;7, 1234 were males (67%) and 608 were females (33%).</p><p class="abstract"><strong>Conclusions:</strong> In a developing country like India, where resources and man power are limited, symptoms of laryngopharyngeal reflux might often be overlooked. The diagnosis and treatment protocol for LPRD needs to be standardized through more long term studies in the manner it has been done for GERD.</p>

scholarly journals Self-Perception of Swallowing-Related Problems in Laryngopharyngeal Reflux Patients Diagnosed with 24-Hour Oropharyngeal pH Monitoring

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Tamer A. Mesallam ◽  
Mohamed Farahat
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Self Perception ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Swallowing Problems ◽  
Significant Difference ◽  
Dysphagia Handicap Index ◽  
Swallowing Difficulty ◽  
The Relationship

Background and Objectives.Swallowing difficulty is considered one of the nonspecific symptoms that many patients with laryngopharyngeal reflux complain of. However, the relationship between laryngopharyngeal reflux and swallowing problems is not clear. The purpose of this work is to explore correlation between swallowing-related problems and laryngopharyngeal reflux (LPR) in a group of patients diagnosed with oropharyngeal pH monitoring and to study the effect of laryngopharyngeal reflux on the patients’ self-perception of swallowing problems.Methods.44 patients complaining of reflux-related problems were included in the study. Patients underwent 24-hour oropharyngeal pH monitoring and were divided into positive and negative LPR groups based on the pH monitoring results. All patient filled out the Dysphagia Handicap Index (DHI) and Reflux Symptom Index (RSI) questionnaires. Comparison was made between the positive and negative LPR groups regarding the results of the DHI and RSI ratings. Also, correlation between DHI scores, RSI scores, and pH monitoring results was studied.Results.Significant difference was reported between positive and negative LPR groups regarding DHI scores, RSI scores, and overall rating of swallowing difficulty. There was significant correlation demonstrated between DHI scores, RSI scores, and 24-hour oropharyngeal pH results.Conclusion.Laryngopharyngeal reflux appears to have a significant impact on patients’ self-perception of swallowing problems as measured by DHI.

scholarly journals Allergic rhinitis, asthma and laryngopharyngeal reflux disease: a cross-sectional study on their reciprocal relations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ameer Kakaje ◽  
Mohammad Marwan Alhalabi ◽  
Ayham Alyousbashi ◽  
Ayham Ghareeb
Keyword(s):  
Allergic Rhinitis ◽  
Reflux Disease ◽  
Medical Condition ◽  
Laryngopharyngeal Reflux ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Cross Sectional ◽  
Wide Range

AbstractAllergic rhinitis (AR) is a common medical condition worldwide. It is an inflammation in the nasal mucosa due to allergen exposure throughout the year. Laryngopharyngeal reflux (LPR) is another medical condition that can overlap with AR. LPR can be considered an extra oesophageal manifestation of gastro-oesophageal reflux disease (GORD) or a different entity. Its diagnosis imposes a real challenge as it has a wide range of unspecific symptoms. Although AR and LPR are not life-threatening, they can severely affect the quality of life for years and cause substantial distress. Moreover, having AR is associated with having asthma which is also in turn associated with GORD. This is a cross-sectional study which used surveys distributed online on Social Media and targeted people across Syria. All participants who responded to the key questions were included. Reflux symptom index (RSI) was used for LPR, and score for allergic rhinitis (SFAR) was used for AR. Demographic questions and whether the participant had asthma were also included in the survey. We found that there was an association between the symptoms of LPR and AR p < 0.0001 (OR, 2.592; 95% CI 1.846–3.639), and their scores were significantly correlated (r = 0.334). Having asthma was associated with LPR symptoms p = 0.0002 (OR 3.096; 95% CI 1.665–5.759) and AR p < 0.0001 (OR 6.772; 95% CI 2.823–16.248). We concluded that there was a significant association between having LPR, AR, and asthma. We need more studies to distinguish between their common symptoms and aetiologies.

A Randomized Clinical Trial of Proton Pump Inhibitors Combined with Traditional Chinese Medicine in the Treatment of Laryngopharyngeal Reflux Disease

2021 ◽  
Author(s):  
Feng Pei ◽  
Wei Jia Hu ◽  
Yi Nan Mao ◽  
Yu Liang Zhao
Keyword(s):  
Proton Pump ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Short Form ◽  
Therapeutic Effects ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Laryngopharyngeal Reflux Disease ◽  
Group A ◽  
Group B

Background:To explore whether combined with TCM based on classical proton pumpinhibitors PPIs therapy can achieve better efficacy for patients withlaryngopharyngeal reflux disease. Methods: There were 150 laryngopharyngeal refluxpatients enrolled and divided into three groups randomly, with 50 cases in each group.Patients in group A were treated with the proton pump inhibitor (PPI) lansoprazole.Patients in group B were treated with lansoprazole combined with Banxia Houpudecoction, and patients in group C were treated with acupuncture treatments and acombination of Chinese and Western medicine. The reflux symptom index (RSI), refluxfinding score (RFS), and quality of life (36 item short form health survey questionnaire)were assessed before and 4 and 8 weeks after treatment. Results: The RSI and RFSscores of the three groups were significantly reduced after treatment (P < 0.001). Ingroup B and C, they were lower than in group A at 8 weeks (P < 0.01). The SF 36 scoreof 3 groups increased after treatment. At both 4 and 8 weeks (P < 0.001), and patientsin groups B and C scored higher than patients in group A (P < 0.001). The total effectiverate of group B and group C was higher than that of group A (P < 0.05). Conclusion:All three treatments have therapeutic effects on the disease, but the efficacy of a PPIalone is not as good as the combined treatments’ efficacies. Moreover, PPI combinedwith Banxia Houpu decoction and/or acupuncture treatment substantially affects lifeimprovement.

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