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Risk factors for laryngopharyngeal reflux

  • Laryngology
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Abstract

The aim of this study was to evaluate the demographic and clinicopathologic characteristics of gastroesophageal reflux disease (GERD) with and without laryngopharyngeal reflux (LPR) to determine the risk factors for the occurrence of LPR in patients with GERD. This is a retrospective study of GERD patients with and without LPR. From the outpatient computer program of our hospital we randomly enrolled 45 GERD patients with LPR into the first group and another 45 GERD patients without LPR to the second group. Medical records of the patients in both groups were examined. All patients underwent upper gastrointestinal system endoscopy. LPR was confirmed by laryngoscopy, and LPR-related laryngoscopy scoring. Non-erosive GERD (NERD), erosive GERD (ERD) and Barrett’s esophagus (BE) were diagnosed by endoscopy and histopathology. Various clinical parameters including status of Helicobacter pylori (H. pylori) infection, topography of gastritis were analyzed. For therapy, lansoprazole in a dosage of 30 mg BID for at least 8 weeks were given to all patients in both groups. GERD patients with and without LPR were compared according to demographic, clinic, endoscopic and histopathological parameters. The results revealed that patients with LPR were younger than the patients without LPR (38.7 ± 10.2 years and 43.8 ± 11.5 years; p = 0.08); however, there was no statistical significance. Patients without LPR showed no gender predilection (55% male) while LPR patients showed male preponderance (71% male). In LPR group, 11 patients (24%) had NERD, while 28 (62%) and 6 (13%) patients had ERD and BE, respectively. Twenty-seven (60%) patients without LPR were diagnosed as NERD, 15 patients (33%) without LPR had ERD and only 3 patients (6.6%) showed the histological findings of BE. The patients in LPR group had higher body mass index. Hiatal hernia was more frequent in the patients with LPR (53%) than in the patients without LPR (24%) (p = 0.005). LPR patients had longer duration of reflux symptoms than the patients without LPR (p = 0.04). H. pylori status was not different in both groups but the patients without LPR had more corpus gastritis than the patients with LPR. Eight weeks of lansoprazole treatment was successful in 71% of patients with LPR, and 86% of patients without LPR. We concluded that male gender, hiatal hernia, longer duration of symptoms, high BMI, having ERD and BE seems as risk factors for the occurrence of LPR in patients with GERD. H. pylori status did not have any effect on the development of LPR. Corpus dominant gastritis may have a protective role against the development of LPR. Proton pump inhibitor therapy is less effective in patients with LPR.

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References

  1. Mosca F, Rossillo V, Leone CA (2006) Manifestations of gastro-pharyngo-laryngeal reflux disease. Acta Otorhinolaryngol Ital 26(5):247–251

    PubMed  CAS  Google Scholar 

  2. Vakil N et al (2006) The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 101(8):1900–1920 (quiz 1943)

    Article  PubMed  Google Scholar 

  3. Dent J et al (2005) Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 54(5):710–717

    Article  PubMed  CAS  Google Scholar 

  4. Wong RK et al (2000) ENT manifestations of gastroesophageal reflux. Am J Gastroenterol 95(8):S15–S22

    Article  PubMed  CAS  Google Scholar 

  5. Gatta L et al (2007) Meta-analysis: the efficacy of proton pump inhibitors for laryngeal symptoms attributed to gastro-oesophageal reflux disease. Aliment Pharmacol Ther 25(4):385–392

    Article  PubMed  CAS  Google Scholar 

  6. Wilson JA et al (1989) Gastroesophageal reflux and posterior laryngitis. Ann Otol Rhinol Laryngol 98(6):405–410

    PubMed  CAS  Google Scholar 

  7. Koufman JA (1991) The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 101(4 Pt 2 Suppl 53):1–78

    PubMed  CAS  Google Scholar 

  8. Dixon MF et al (1996) Classification, grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 20(10):1161–1181

    Article  PubMed  CAS  Google Scholar 

  9. Belafsky PC, Postma GN, Koufman JA (2002) Validity and reliability of the reflux symptom index (RSI). J Voice 16:274–277

    Article  PubMed  Google Scholar 

  10. Belafsky PC, Postma GN, Koufman JA (2001) The validity and reliabilty of reflux finding score (RFS). Laryngoscope 111:1313–1317

    Article  PubMed  CAS  Google Scholar 

  11. Ylitalo R, Lindestad PA, Hertegard S (2004) Is pseudosulcus alone a reliable sign of gastroesophago-pharyngeal reflux? Clin Otolaryngol Allied Sci 29(1):47–50

    Article  PubMed  CAS  Google Scholar 

  12. Hill RK et al (2004) Pachydermia is not diagnostic of active laryngopharyngeal reflux disease. Laryngoscope 114(9):1557–1561

    Article  PubMed  Google Scholar 

  13. Halum SL et al (2005) Patients with isolated laryngopharyngeal reflux are not obese. Laryngoscope 115(6):1042–1045

    Article  PubMed  Google Scholar 

  14. Koufman JA et al (2002) Prevalence of esophagitis in patients with pH-documented laryngopharyngeal reflux. Laryngoscope 112(9):1606–1609

    Article  PubMed  CAS  Google Scholar 

  15. Suazo J, Facha MT, Valdovinos MA (1998) Case and control study of atypical manifestations in gastroesophageal reflux disease. Rev Invest Clin 50(4):317–322

    PubMed  CAS  Google Scholar 

  16. Perry KA et al (2008) The integrity of esophagogastric junction anatomy in patients with isolated laryngopharyngeal reflux symptoms. J Gastrointest Surg 12(11):1880–1887

    Article  PubMed  Google Scholar 

  17. Reavis KM, Morris CD, Gopal DV, Hunter JG, Jobe BA (2004) Laryngopharyngeal reflux symptoms better predict the presence of esophageal adenocarcinoma than typical gastroesophageal reflux symptoms. Ann Surg 239(6):849–856

    Article  PubMed  Google Scholar 

  18. Kahrilas PJ (2001) Supraesophageal complications of reflux disease and hiatal hernia. Am J Med 111(Suppl 8A):51S–55S

    Article  PubMed  Google Scholar 

  19. Mjones AB et al (2007) Hoarseness and misdirected swallowing in patients with hiatal hernia. Eur Arch Otorhinolaryngol 264(12):1437–1439

    Article  PubMed  Google Scholar 

  20. Abou-Ismail A, Vaezi MF (2011) Evaluation of patients with suspected laryngopharyngeal reflux: a practical approach. Curr Gastroenterol Rep 13(3):213–218

    Article  PubMed  Google Scholar 

  21. Ford CN (2005) Evaluation and management of laryngopharyngeal reflux. JAMA 294(12):1534–1540

    Article  PubMed  CAS  Google Scholar 

  22. Koufman JA, Aviv JE, Casiano RR, Shaw GY (2002) Laryngopharyngeal reflux: position statement of the committee on speech, voice and swallowing disorders of the American Academy of Otolaryngology—Head and Neck Surgery. Otolaryngol Head Neck Surg 127:32–35

    Article  PubMed  Google Scholar 

  23. Qadeer MA, Phillips CO, Lopez AR et al (2006) Proton pump inhibitor therapy for suspected GERD-related chronic laryngitis: a meta-analysis of randomized controlled trials. Am J Gastroenterol 101:2646–2654

    Article  PubMed  CAS  Google Scholar 

  24. Gao BX et al (2006) The roles of Helicobacter pylori and pattern of gastritis in the pathogenesis of reflux esophagitis. Zhonghua Yi Xue Za Zhi 86(38):2674–2678

    PubMed  Google Scholar 

  25. Abdul-Razzak KK, Bani-Hani KE (2007) Increased prevalence of Helicobacter pylori infection in gastric cardia of patients with reflux esophagitis: a study from Jordan. J Dig Dis 8(4):203–206

    Article  PubMed  Google Scholar 

  26. Hammer HF (2009) Reflux-associated laryngitis and laryngopharyngeal reflux: a gastroenterologist’s point of view. Dig Dis 27(1):14–17

    Article  PubMed  Google Scholar 

  27. Reichel O, Issing WJ (2007) Should patients with pH-documented laryngopharyngeal reflux routinely undergo oesophagogastroduodenoscopy? A retrospective analysis. J Laryngol Otol 121(12):1165–1169

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Elif Ayanoglu Aksoy.

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Saruç, M., Aksoy, E.A., Vardereli, E. et al. Risk factors for laryngopharyngeal reflux. Eur Arch Otorhinolaryngol 269, 1189–1194 (2012). https://doi.org/10.1007/s00405-011-1905-3

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  • DOI: https://doi.org/10.1007/s00405-011-1905-3

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