scholarly journals Refluks Laringofaring

2020 ◽  
Vol 2 (1) ◽  
pp. 64-7
Author(s):  
Wita Aulia
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Fiber Optic ◽  
Laryngopharyngeal Reflux ◽  
Reflux Finding Score ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Pharmacological Management ◽  
Lying Down

Laryngopharyngeal reflux (LPR) is a disease in which retrograde flow occurs from the contents of the stomach to the larynx and pharynx and then this material is in contact with the upper esophagus. This disease is different from gastroesophageal reflux disease (GERD). A man, 58 years old laborer, came with complaints of hoarseness since 3 months ago. Complaints are accompanied by swallowing pain and throat pain that has worsened since 1 month. The patient also complained that the sound had disappeared within 1 month. The patient has a history of smoking and claims that he has had a long-standing heartburn. Physical examination found blood pressure of 150/90 mmHg, pulse 102 x/minute, breathing 20 x/minute, temperature 37.9ºC. Investigations were done using the Fiber Optic Laryngoscope (LFO) and revealed a rigid epiglottis and bilateral hyperemic arytenoids and minimal edema. RSI score calculation results have been 18 and RFS score results have been 9. This pateint’s diagnosis is Laryngopharyngeal reflux (LPR). Pharmacological management for this patient is Omeprazole 40 mg 2x1 tablet, Sucralfate syrup 3x1 teaspoon, and N-acetylcysteine 3x1 tablet. Non-pharmacological management is by telling the patient to give 2 hours time between eating and lying down. The patient is also told to reduce the consumption of fatty foods, coffee, soda, alcohol, and low-acid diets, and position the head slightly higher when lying down. Keywords: Fiber Optic Laryngoscope, laryngopharyngeal reflux, Reflux Finding Score, Reflux Symptom Index     Refluks laringofaring adalah penyakit dimana terjadi aliran retrograde dari isi lambung ke laring dan faring kemudian cairan ini bersentuhan dengan saluran esofagus bagian atas. Penyakit ini berbeda dengan gastroesophageal reflux disease (GERD). Seorang laki-laki, usia 58 tahun seorang buruh datang dengan keluhan suara serak sejak 3 bulan yang lalu. Keluhan disertai dengan nyeri menelan dan nyeri tenggorokan yang memberat sejak 1 bulan ini. Pasien juga mengeluhkan suara sempat hilang timbul dalam 1 bulan ini. Pasien memiliki riwayat merokok dan mengaku bahwa menderita sakit maag sejak lama. Pemeriksaan fisik didapatkan tekanan darah 150/90 mmHg, nadi 102 x/menit, pernapasan 20 x/menit, suhu 37,9ºC. Pada pemeriksaan penunjang Fiber Optic Laryngoscope (LFO), didapatkan epiglotis yang kaku serta aritenoid hiperemis bilateral dan edema minimal. Pada perhitungan skor RSI didapatkan hasil 18 dan skor RFS didapatkan hasil 9. Diagnosis pada pasien ini adalah refluks laringofaring. Penatalaksanaan pada pasien berupa medikamentosa yaitu Omeprazole tablet 40 mg 2x1 tablet, Sukralfat syrup 3x1 sendok teh, dan N-asetilsistein 3x1 tablet. Non-medikamentosa dengan memberitahukan kepada pasien untuk jarak makan dan berbaring kurang lebih 2 jam, mengurangi konsumsi makanan berlemak, kopi, soda, alkohol, dan diet rendah asam, serta memberitahukan kepada pasien untuk memposisikan kepala sedikit lebih tinggi saat berbaring Kata kunci: Fiber Optic Laryngoscope, refluks laringofaring, Reflux Finding Score, Reflux Symptom Index

Gastroesophageal reflux disease and salivary pepsin in patients with heterotopic gastric mucosa in the upper esophagus

2021 ◽  
Author(s):  
Xin Xiong ◽  
Suyu He ◽  
Fei Xu ◽  
Zhihong Xu ◽  
Xiumei Zhang ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastric Mucosa ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Acid Reflux ◽  
Heterotopic Gastric Mucosa ◽  
Control Group ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Demeester Score

Summary Background Heterotopic gastric mucosa in the upper esophagus (HGMUE) is reported to be related to gastroesophageal reflux disease (GERD). This study investigated the prevalence of GERD and the use of salivary pepsin to diagnose gastroesophageal reflux, especially proximal reflux, in HGMUE patients. Methods One hundred and fifty-three HGMUE patients and 50 healthy volunteers were studied. All subjects took a reflux symptom index questionnaire (RSI); underwent endoscopy, barium esophagogram, high-resolution manometry (HRM), and 24-hour multichannel intraluminal impedance-pH-metry (MII-pH); and salivary pepsin test. Results Ninety-five (62.1%) HGMUE patients but no control subjects were diagnosed with GERD. The salivary pepsin concentration, RSI score, DeMeester score, acid exposure time (AET), total reflux episodes, proximal acidic reflux episodes, and proximal weakly acidic reflux episodes were significantly higher in the HGMUE group than in the control group (P < 0.05). The salivary pepsin test showed a sensitivity of 85.9% and specificity of 56.9% for diagnosing GERD using the optimal cut-off value of 75 ng/mL. One hundred and seven (69.9%) and 46 (30.1%) HGMUE patients were categorized as pepsin (+) and pepsin (−), respectively when 75 ng/mL was used as a cut-off value. Male sex, RSI, AET, and proximal acid reflux episodes were positive predictive factors for the occurrence of pepsin (+) in HGMUE patients. Conclusions GERD, especially GERD with proximal acid reflux and related symptoms, was common in HGMUE patients. The salivary pepsin test could be an additional useful test for testing reflux in HGMUE patients, but it will not replace the MII-pH.

scholarly journals Prevalence and Symptomatology of Laryngopharyngeal Reflux Disease in a Medical College Hospital in Kerala

2021 ◽  
Vol 8 (27) ◽  
pp. 2467-2471
Author(s):  
Binu Raju George ◽  
Ajayan P.V ◽  
Saify Samad
Keyword(s):  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Reflux Symptom ◽  
Common Symptom ◽  
Reflux Finding Score ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Female Ratio ◽  
Medical College ◽  
Laryngopharyngeal Reflux Disease

BACKGROUND Laryngopharyngeal reflux is a common clinical condition encountered in Otolaryngology practice. It is one of the major causes of laryngeal inflammation. It presents with a constellation of symptoms making the diagnosis difficult. Reflux Symptom Index and Reflux Finding Score are two tools which aid in diagnosis of Laryngopharyngeal reflux. The main objective of this study was to study the agent, host and environment factors of epidemiology of patients with laryngopharyngeal reflux disease using Reflux Symptom Index and Reflux Finding Score. METHODS A descriptive study was conducted on 100 patients attending the Department of Otorhinolaryngology, Government Medical College and Hospital, Thrissur, Kerala. The study period was for one year from December 2017 to December 2018. Demographic data of the patients was recorded, and patients were evaluated for Laryngopharyngeal reflux disease using Reflux Symptom Index and Reflux Finding Score using 70 degree / flexible nasopharyngolaryngoscopy. The clinical data collected was then tabulated and analysed. RESULTS From the study conducted in 100 patients, 59 % were females and 41 % males. Most common symptom noted was frequent clearing of throat which was present in 88 % cases. Least frequent symptom was choking episode (in 5 %). CONCLUSIONS The prevalence of Laryngopharyngeal Reflux Disease was commonest in the 31 to 40 years age group with mean age was 37.8 ± 2.35 years. The male to female ratio were 1:1.43. The disease was common in labourers and housewives. Risk factors were consumption of tea/coffee, inadequate sleep of less than 6 hrs. Lower socioeconomic group populations were more vulnerable than higher income group. The RSI score was between 13 and 15 in 53 % of the patients. KEYWORDS Laryngopharyngeal Reflux, Reflux Symptom Index, Reflux Finding Score

Transoral incisionless fundoplication with an ultrasonic surgical endostapler for the treatment of gastroesophageal reflux disease: 12-month outcomes

Endoscopy ◽  
2020 ◽  
Vol 52 (06) ◽  
pp. 469-473
Author(s):  
Pier Alberto Testoni ◽  
Sabrina Testoni ◽  
Giorgia Mazzoleni ◽  
Giuseppe Pantaleo ◽  
Maria Bernadette Cilona ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Reflux Symptom Index ◽  
Transoral Incisionless Fundoplication ◽  
Symptom Index ◽  
High Resolution Manometry ◽  
Related Quality ◽  
Health Related

Background Transoral incisionless fundoplication (TIF) with the Medigus ultrasonic surgical endostapler (MUSE) is a new intervention for the treatment of the gastroesophageal reflux disease (GERD). The aim of this study was to assess the 12-month clinical, functional, and endoscopic effects of TIF by MUSE. Methods Patients undergoing MUSE completed the GERD-Health Related Quality of Life (GERD-HRQL) and Reflux Symptom Index (RSI) questionnaires, and underwent endoscopy, esophageal 24-hour pH-impedance recording, and high resolution manometry (HRM) before the TIF procedure and 12 months later, or after 6 months for HRM. Results Among the 37 patients treated, esophageal intubation was not possible in one and esophageal perforation occurred in another. Clinical and endoscopic follow-up at 12 months was completed in 20 patients, with significant improvements in GERD-HRQL, RSI, heartburn, regurgitation scores, and proton pump inhibitor (PPI) consumption observed. One patient required surgery for persisting symptoms. Functional follow-up was possible in 13 patients and showed no significant improvements in the analyzed parameters. Conclusions TIF with MUSE significantly improved symptoms at 1-year follow-up, allowing the consumption of PPIs to be stopped or halved in 90 % of patients.

scholarly journals Pengaruh suplementasi zinc terhadap perbaikan klinis penderita laryngopharyngeal reflux disease

2015 ◽  
Vol 44 (2) ◽  
pp. 131
Author(s):  
Chrisma Pramana ◽  
Muyassaroh Muyassaroh ◽  
Dwi Antono
Keyword(s):  
Clinical Improvement ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Reflux Symptom ◽  
Control Group ◽  
Reflux Finding Score ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Post Test ◽  
Laryngopharyngeal Reflux Disease

Latar Belakang: Laryngopharyngeal Reflux Disease (LPRD) menyebabkan kerusakan mukosa laring dan faring.  Zinc adalah kelompok zat gizi mikro yang berperan dalam inhibisi terhadap sekresi asam lambung, pembentukan carbonic anhidrase, dan reepitelisasi. Tujuan: Mengetahui pengaruh suplementasi zinc pada perbaikan klinis penderita LPRD. Metode: Penelitian eksperimental dengan pre-post test randomized control trial pada penderita LPRD di klinik THT-KL RSUP Dr. Kariadi yang memenuhi kriteria penelitian. Kelompok kontrol diberikan omeprazol dan plasebo, sedangkankelompok perlakuan diberikan omeprazol dan zinc. Pemberian terapi dilakukan selama 4 minggu kemudian dianalisis skoring Reflux Symptom Index (RSI) dan Reflux Finding Score (RFS) sebelum terapi dan sesudah terapi pada kedua kelompok. Analisis data dengan uji Wilcoxon dan independent t test. Hasil: Sampel sebanyak 27 penderita, kelompok kontrol 13 orang, dan kelompok perlakuan 14 orang. Skor RSI sebelum terapi pada kelompok kontrol 22,92±6,982, sedangkan pada kelompok perlakuan19,57±6,136 (p=0,223). Skor RFS sebelum terapi pada kelompok kontrol 10,46±2,367, sedangkan pada kelompok perlakuan 10,86±2,983 (p=0,767). Skor RSI sesudah terapi pada kelompok kontrol 15,92±8,893, sedangkan pada kelompok perlakuan 9,07±6,294 (p=0,034). Skor RFS sesudah terapi pada kelompok kontrol 6,54±1,808, sedangkan pada kelompok perlakuan 4,54±2,240 (p=0,024). Kesimpulan: Suplementasi zinc berpengaruh pada perbaikan klinis penderita LPRD. Perbaikan klinis penderita LPRD yang diberikan suplementasi zinc lebih baik dibanding tanpa suplementasi zinc. Kata kunci: Reflux Symptom Index, Reflux Finding Score, zinc ABSTRACTBackground: Laryngopharyngeal Reflux Disease (LPRD) could cause mucosal damage on larynx and pharynx. Zinc is microsubstance which has a role as inhibiting factor to gastric acid, carbonic anhidrase establishment, and reepitelization. Objective: The study aimed to know the effect of zinc onLPRD patient’s clinical improvement. Methods: Experimental study with pre-post test randomized control trial on LPRD patients in ENT center RSUP Dr. Kariadi. Control group was prescribed omeprazole and placebo,while interventioned group was prescribed omeprazole and zinc. The treatment was conducted for 4 weeks, and Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) were analyzed before and after treatment for both groups. Data were analyzed with Wilcoxon’s test and independent t-test. Result: The sample was 27 patients, consisted of 13 patients in control group and 14 patients in interventioned group. RSI score before theraphy on control group was 22,92±6,982, on interventioned group 19,57±6,136(p=0,223). RFS score on control group 10,46±2,367, on interventioned group 10,86±2,983 (p=0,767). RSI after theraphy on control group 15,92±8,89,3 while on interventioned group 9,07±6,294 (p=0,034). RFS score after theraphy on control group 6,54±1,808, while on interventioned group 4,54±2,240 (p=0,024). Conclusion: This study found that zinc supplementation had an effect on clinical improvement on patients with LPRD. Clinical improvement on LPRD patients who got zinc supplementation was found better than without zinc supplementation.Keywords: Reflux Symptom Index, Reflux Finding Score, Zinc

scholarly journals Sex-Based Differences in pH Parameters and Esophageal Impedance of Patients With Gastroesophageal Reflux Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Bixing Ye ◽  
Yanjuan Wang ◽  
Lin Lin ◽  
Liuqin Jiang ◽  
Meifeng Wang
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Ph Monitoring ◽  
Acid Reflux ◽  
Mucosal Barrier ◽  
Esophageal Mucosa ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Esophageal Impedance

Background/Aims: The incidence of reflux esophagitis (RE) has a striking predominance in males. Conversely, non-erosive reflux disease (NERD) is more common in females. This imbalance of gastroesophageal reflux disease (GERD) implies sex-related differences in its pathogenesis. However, limited studies have analyzed the sex-based differences in pH parameters and esophageal impedance of GERD patients.Methods: This study evaluated sex-based pathogenesis differences by comparing reflux episodes, mean nocturnal baseline impedance (MNBI) values, and post-reflux swallow-induced peristaltic wave (PSPW) index values of males with GERD and females with GERD using 24-h multichannel intraluminal impedance and pH monitoring.Results: We analyzed 181 patients (102 males and 79 females) with GERD. Reflux symptom index (RSI) scores were higher in females than that in males (P < 0.05). Males had significantly longer acid exposure times, higher DeMeester scores, and more acid reflux episodes than females (P < 0.05). Females had more instances of weakly acidic reflux than males (P < 0.01). The PSPW index values of males and females were similar (P > 0.05). Compared with females, males had lower MNBI values for the mid and distal esophagus (P < 0.05). However, with increasing age, the MNBI values of females decreased more rapidly than those of males. MNBI values of elderly patients of both sexes older than 60 years were similar.Conclusions: Acid reflux is more likely to occur in males; however, females tend to have more instances of weakly acid reflux. The integrity of the esophageal mucosa is more fragile in males than in females; however, the esophageal mucosal barrier attenuates more rapidly with increasing age in females than in males.

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.

Usefulness of Matrix Metalloproteinase-7 in Saliva as a Diagnostic Biomarker for Laryngopharyngeal Reflux Disease.

2021 ◽  
Author(s):  
Nu-Ri Im ◽  
Byoungjae Kim ◽  
Kwang-Yoon Jung ◽  
Seung-Kuk Baek
Keyword(s):  
Matrix Metalloproteinase ◽  
Sensitivity And Specificity ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Diagnostic Methods ◽  
Reflux Symptom Index ◽  
Enzyme Activity Assay ◽  
Symptom Index ◽  
Laryngopharyngeal Reflux Disease ◽  
Matrix Metalloproteinase 7

Abstract Introduction Several diagnostic methods are currently being used to diagnose LPRD (laryngopharyngeal reflux disease), but have the disadvantage of being invasive, subjective, or expensive. Objectives Our purpose in this study was to investigate the correlation between pepsin and MMP-7 (Matrix Metalloproteinase-7) in pharyngeal secretions of subjects according to RSI (Reflux Symptom Index) score to find out the diagnostic value of MMP-7. Method We recruited 173 subjects aged between 19 and 85 years who completed the RSI scale. All samples were taken after waking up, and the amount of the pepsin and MMP-7 in saliva were measured by means of an enzyme activity assay. Results There was a significant increase of pepsin and MMP-7 activity in the study group with an RSI score of 13 or higher. The sensitivity and specificity of MMP-7 for predicting the possibility of an RSI of 13 or more was higher than that of pepsin. When MMP-7 and pepsin were combined, this sensitivity and specificity increased. Conclusion An enzyme assay of MMP-7 in saliva may be a noninvasive and easy technique for diagnosing LPRD.

Sign in / Sign up

Export Citation Format

Share Document