Laryngopharyngeal Reflux and GERD

2021 ◽  
Author(s):  
Shumon Ian Dhar ◽  
Lee Akst
Keyword(s):  
Key Words ◽  
Laryngopharyngeal Reflux ◽  
Evidence Based ◽  
Mechanism Of Injury ◽  
Esophageal Reflux ◽  
Laryngeal Injury

Since the early 1990s, the consequences of extra-esophageal reflux in the larynx have been recognized to be related to a variety of laryngeal symptoms with certain endoscopic manifestations. The paper by Dr. Koufman described various types of laryngeal injury which were attributed to extra-esophageal reflux also known as laryngopharyngeal reflux (LPR). The mechanism of injury was postulated to be a consequence of acid refluxate as well as from pepsin. Since that time there has been a surge of literature devoted to the topic of LPR seeking to refine its diagnosis, elucidate its pathophysiology, and treat its symptoms and sequelae. Our goal in this chapter is to provide a balanced, evidence-based framework for identifying LPR and providing treatment while balancing the benefits versus the risks of overtreatment and escalating therapy. This review contains 13 figures, 7 tables and 49 references. Key Words: LPR, GERD, PPI, RSI, TLESR

Premature birth (Clinical lecture)

2018 ◽  
pp. 9-12
Author(s):  
I.B. Ventskovskaya ◽  
◽  
V.V. Bila ◽  
O.S. Countryside ◽  
◽  
...  
Keyword(s):  
Magnesium Sulfate ◽  
Key Words ◽  
Gestational Age ◽  
Evidence Based Medicine ◽  
Premature Birth ◽  
Preterm Labor ◽  
Evidence Based ◽  
Advantages And Disadvantages ◽  
Based Medicine ◽  
Tocolytic Agents

The article presents modern views on the pathogenesis of preterm labor, their relevance and classification. From the perspective of evidence-based medicine methods of prevention are considered. A comparison of the main tocolytic agents, their advantages and disadvantages is presented. Key words: premature birth, perinatal and infantile mortality, tocolysis, magnesium sulfate, gestational age.

Acidic Pharyngeal Reflux Does Not Correlate with Symptoms and Laryngeal Injury Attributed to Laryngopharyngeal Reflux

2018 ◽  
Vol 64 (5) ◽  
pp. 1270-1280 ◽  
Author(s):  
Martin Duricek ◽  
Peter Banovcin ◽  
Tatiana Halickova ◽  
Rudolf Hyrdel ◽  
Marian Kollarik
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Laryngeal Injury ◽  
Pharyngeal Reflux

scholarly journals Using Medline to achieve an evidence-based approach to diagnostic clinical biochemistry

2002 ◽  
Vol 39 (4) ◽  
pp. 345-350 ◽  
Author(s):  
Andrew M Fielding ◽  
Anne Powell
Keyword(s):  
Key Words ◽  
Literature Search ◽  
Clinical Biochemistry ◽  
Evidence Based ◽  
Search Technique ◽  
National Library ◽  
Mesh Terms ◽  
The Us ◽  
Minimum Number ◽  
Structured Approach

Medline is the US National Library of Medicine database that is used for searching the medical biochemistry literature. The database is structured using medical subject subheadings (MeSH terms) to classify the content of references; indexing is done manually using MeSH terms as key words. Searching the database effectively means finding the maximum number of relevant references together with the minimum number of irrelevant ones. This article is aimed at explaining the limitations of Medline and suggesting some solutions to key problems. The goal is that users can improve their literature search technique by employing a structured approach. As usual, asking relevant questions before starting a search is essential.

scholarly journals Validation of Peptest™ in Patients with Gastro-Esophageal Reflux Disease and Laryngopharyngeal Reflux Undergoing Impedance Testing

2019 ◽  
Vol 28 (4) ◽  
pp. 383-387 ◽  
Author(s):  
Serhat Bor ◽  
Doga Capanoglu ◽  
Rukiye Vardar ◽  
Andrew D Woodcock ◽  
Jeanine Fisher ◽  
...  
Keyword(s):  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Esophageal Reflux ◽  
First Line ◽  
Multichannel Intraluminal Impedance ◽  
Intraluminal Impedance ◽  
Reflux Event ◽  
In Vitro Diagnostic ◽  
Impedance Testing

Background and Aims: Pepsin in the gastric refluxate is a marker for a prior reflux event and rapid detection might be achieved using the Peptest™, an in vitro diagnostic medical device. The aim of this study was to validate the use of Peptest™ to reliably diagnose reflux in patients with gastro-esophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) disease diagnosed with multichannel intraluminal impedance/ pHmetry (MII-pH). Methods: 20 reflux patients were recruited of whom 10 had classical GERD and 10 had LPR. All patients underwent MII-pH and provided expectorated saliva samples when a MII-pH reflux event was observed, or reflux symptoms were experienced, and all were tested for the presence of pepsin using the Peptest™. Results: Pepsin was detected in 31 out of 45 samples (68.9%). At least 1 positive pepsin result was seen in 16 patients (80%) and this was the same, irrespective of the GERD or LPR diagnosis. Peptest™ had a positive predictive value of 69% to detect MII-pH reflux events. Conclusions: Peptest™ is a good first-line diagnostic procedure to use in reflux sufferers to confirm the presence of reflux.

scholarly journals SARS-CoV-2: An Ophthalmological Insight into the Pandemic; Challenges and Management Strategies

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Jaya Kaushik ◽  
◽  
Sandeep Shankar ◽  
Anargh V ◽  
Renu M ◽  
...  
Keyword(s):  
Key Words ◽  
Management Strategy ◽  
Management Strategies ◽  
Evidence Based ◽  
Effective Management ◽  
Protective Measures ◽  
Insight Into

Objective: To formulate a protocol for safe and effective management of an ophthalmologic practice in a hospital or a clinic during the Covid - 19 pandemic. Methods and analysis: Literature was reviewed regarding Covid-19 pandemic and ophthalmology. The following key words were used. Covid-19, telemedicine, challenges, management strategy. Result: An efficient protocol for ophthalmology practice during the Covid-19 pandemic was established which covered various protective measures that are essential and vital in the Covid-19 pandemic. Conclusion: An evidence-based protocol was formulated which may be modified in future as per the latest developments and trends in the ongoing pandemic.

Prevention and Management of Obstetric Perineal Lacerations

2018 ◽  
Author(s):  
Helai Hesham ◽  
Lori R Berkowitz
Keyword(s):  
Risk Factors ◽  
Pelvic Floor ◽  
Key Words ◽  
Evidence Based ◽  
Operative Delivery ◽  
Prevention Strategies ◽  
Perineal Lacerations ◽  
Vaginal Deliveries ◽  
Perineal Massage

Vaginal deliveries vary widely in the trauma they may introduce to the pelvic floor as does the management of such trauma. Labor, operative deliveries, lacerations, and episiotomies all present unique risk factors for both acute and long-term pelvic floor complications. Of these risk factors, perineal lacerations are the most commonly encountered event that women experience during vaginal childbirth. This review attempts to analyze obstetric perineal lacerations, their management, and potential prevention strategies to enhance pelvic floor health. With standardized management based on evidence based strategies and care during both delivery and postpartum, clinicians can decrease higher order lacerations and their possible sequela. This review contains 12 figures, 1 table and 36 references Key Words: episiotomy, laceration, laceration repair, obstetric, operative delivery, perineal massage, prevention, pudendal block

Impact of different pH thresholds for 24-hour dual probe pH monitoring in patients with suspected laryngopharyngeal reflux

2007 ◽  
Vol 122 (5) ◽  
pp. 485-489 ◽  
Author(s):  
O Reichel ◽  
W J Issing
Keyword(s):  
Healthy Volunteers ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Standard Test ◽  
Normative Values ◽  
Area Index ◽  
Gold Standard Test ◽  
Laryngeal Injury ◽  
Reflux Area Index ◽  
Dual Probe

AbstractObjectives:The gold standard test for laryngopharyngeal reflux is 24-hour pH monitoring, which determines the reflux area index with a pH threshold of less than four (i.e. the reflux area index four). However, refluxed pepsin is able to cause laryngeal injury at pH levels above five.Study design:Prospective study.Materials and methods:In order to establish normative values for a reflux area index with a pH threshold of less than five (i.e. the reflux area index five), 29 healthy volunteers underwent pH monitoring. In 45 patients with suspected laryngopharyngeal reflux, reflux area index four and reflux area index five were determined by pH study.Results:In healthy volunteers, the reflux area index five was 72.6 (95th percentile). In 29 of 44 patients, laryngopharyngeal reflux was diagnosed due to a reflux area index four of greater than 6.3. However, the reflux area index five revealed laryngopharyngeal reflux in six more patients.Conclusions:For exact analysis of pH monitoring results, two pH thresholds (less than four and less than five) must be considered. Further studies with a larger number of healthy volunteers are necessary in order to reveal normative values for the reflux area index five parameter.

scholarly journals Quantitative Evaluation of Laryngopharyngeal Reflux with Reflux Finding Score (RFS).

2019 ◽  
Vol 3 (2) ◽  
pp. 105
Author(s):  
Irfan UL Shamas
Keyword(s):  
Medical Management ◽  
District Hospital ◽  
Laryngopharyngeal Reflux ◽  
Symptomatic Improvement ◽  
Retrograde Flow ◽  
Reflux Finding Score ◽  
Esophageal Reflux ◽  
Lifestyle Modifications ◽  
Gastric Contents

Introduction: Laryngopharyngeal reflux (LPR) also known as extra esophageal reflux disease refers to retrograde flow of gastric contents to the upper aero-digestive tract. Belafsky, Postma, and Koufman have developed the reflux finding score (RFS) to diagnose LPR. My aim was to test the score in patients with LPR to reveal the validity and effectiveness of present medical management based on changes in RFS.Materials and Methods: One hundred patients with LPR were examined prospectively in District Hospital Pulwamawith 70 degree Hopkins endoscope and RFS was evaluated both before start and completion of a set medical management with lifestyle modifications. 76.7% patients reported symptomatic improvement after one month of treatment. There was no significant quantitative decrease in RFS after one month of treatment.Conclusion: Based on this study RFS is a reliable and quantitative system to evaluate and follow up patients at the time of diagnosis and subsequent evaluation after therapy.International Journal of Human and Health Sciences Vol. 03 No. 02 April’19. Page: 105-108

Sign in / Sign up

Export Citation Format

Share Document