Title:Prevalence of Gastro-esophageal Reflux Disease in Suspected Laryngo-
pharingeal Reflux Unresponsive to Proton-pump Inhibitors
Volume: 16
Issue: 4
Author(s): Antonio Tursi, Antonio Pio Palieri*, Michele Tiano and Walter Elisei
Affiliation:
- Territorial Gastroenterology Service, ASL FG, Foggia,Italy
Keywords:
Laryngopharyngeal reflux, laryngopharyngeal symptoms, gastroesophageal reflux disease, proton pump inhibitors, treatment, laryngoscopic diagnosis.
Abstract: Background: Laryngopharyngeal Reflux (LPR) may be part of Gastroesophageal Reflux
Disease (GERD). However, sometimes suspected LPR seems refractory to Proton Pump Inhibitors
(PPI), questioning therefore the GERD diagnosis. Our aim was to evaluate the real-life prevalence
of GERD in patients with a recent laryngoscopic diagnosis of LPR, and unresponsive to PPI.
We also assessed whether other causes than GERD could explain the laryngoscopic findings in
those patients.
Methods: We retrospectively analyzed patients with the diagnosis of LPR, and unresponsive to
PPI. Those patients must have been investigated by: upper gastrointestinal endoscopy with biopsies;
multichannel intraluminal impedance and pH monitoring (MII-pH); X-ray of the chest and/or
of the paranasal sinuses; hormonal thyroid assessment; prick tests to assess food and/or inhalants
and pollen allergy.
Results: We enrolled 28 patients (18, 64.3%, males and 10, 35.7%, females; median, IQR age 39.4,
21-75 yrs). Endoscopic hiatal hernia was found in 9/28 (32.1%) patients; the MII-pH analysis
showed abnormality in 2/28 (7.14%) patients (both having also GERD symptoms); Chest X-ray
found chest diseases in 2/28 (7.14%) patients and X-rays of the paranasal sinuses found sinusitis in
1/28 (3.6%); 2/28 (7.14%) patients had hyperthyroidism; food and/or inhalants and pollen allergy
was found in 9 (32.1%) patients. In 12/28 (42.9%) patients, any of the investigated diseases was
found.
Conclusions: This study found that the real prevalence of GERD in patients with a recent laryngoscopic
diagnosis of LPR, and unresponsive to PPI, is low. Moreover, more than 40% of them did
not show any of the investigated diseases in real life.
