Esophagopharyngeal distribution of refluxed gastric acid in patients with reflux laryngitis

Shaker, Reza; Milbrath, Mary M.; Ren, Junlong; Toohill, Robert J.; Hogan, Walter J.; Li, Qun; Hofmann, Candy

doi:10.1016/0016-5085(95)90646-0

Cited by 242 publications

(204 citation statements)

References 13 publications

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“…The results concerning the esophageal motor activity in the present study were similar to those of Shaker et al (26) and Katz (10) . Pathologic gastroesophageal reflux was demonstrated by prolonged esophageal pHmetry in 88% of GERD patients with dysphonia, similar to levels found by other researchers (17,31) .…”

Section: Discussionsupporting

confidence: 93%

Gastroesophageal reflux disease and vocal disturbances

Henry

Martins

Lerco

et al. 2011

Arq. Gastroenterol.

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CONTEXT: Gastroesophageal reflux disease is a chronic disease in which gastroduodenal contents reflux into the esophagus. The clinical picture of gastroesophageal reflux disease is usually composed by heartburn and regurgitation (typical manifestations). Atypical manifestations (vocal disturbances and asthma) may also be complaint. OBJECTIVE: To analyse the clinical, endoscopic, manometric and pHmetric aspects of patients suffering from gastroesophageal reflux disease associated with vocal disturbances. METHODS: Fifty patients with gastroesophageal reflux disease were studied, including 25 with vocal disturbances (group 1 - G1) and 25 without these symptoms (group 2 - G2). All patients were submitted to endoscopy, manometry and esophageal pHmetry (2 probes). The group 1 patients were submitted to videolaryngoscopy. RESULTS: Endoscopic findings: non-erosive reflux disease was observed in 95% of G1 patients and 88% of G2. Videolaryngoscopy: vocal fold congestion, asymmetry, nodules and polyps were observed in G1 patients. Manometric findings: pressure in the lower esophageal sphincter (mm Hg): 11.6 ± 5.2 in G1 and 14.0 ± 6.2 in G2 (P = 0.14); pressure in the upper esophageal sphincter (mm Hg): 58.4 ± 15.9 in G1 and 69.5 ± 30.7 in the controls. pHmetric findings: De Meester index: 34.0 ± 20.9 in G1 and 15.4 ± 9.4 in G2 (P<0.001); number of reflux episodes in distal probe: 43.0 ± 20.4 in G1 and 26.4 ± 17.2 in G2 (P = 0.003); percentage of time with esophageal pH value lower than 4 units (distal sensor): 9.0% ± 6.4% in G1 and 3.4% ± 2.1% in G2 (P<0.001); number of reflux episodes in proximal probe: 7.5 ± 10.9 in G1 and 5.3 ± 5.7 in G2 (P = 0.38); percentage of time with esophageal pH values lower than 4 units (Proximal probe): 1.2 ± 2.7 in G1 and 0.5 ± 0.7 in G2 (P = 0.21). CONCLUSIONS: 1) The clinical, endoscopic, and manometric findings observed in patients with vocal disturbance do not differ from those without these symptoms; 2) gastroesophageal reflux intensity is higher in patients with vocal disturbance; 3) patients without vocal disturbance can also present reflux episodes in the proximal probe.

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Section: Discussionsupporting

confidence: 93%

Gastroesophageal reflux disease and vocal disturbances

Henry

Martins

Lerco

et al. 2011

Arq. Gastroenterol.

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“…This kind of reflux pattern has previously been found in patients with subglottic stenosis and laryngeal cancer.l'' vocal nodules.l-' and reflux laryngitis. IO ,12 The short duration of the reflux episodes may explain the low incidence of classic reflux symptoms in patients with contact granuloma.…”

Section: Discussionmentioning

confidence: 99%

Extraesophageal Reflux in Patients with Contact Granuloma: A Prospective Controlled Study

Ylitalo¹,

Ramel²

2002

Ann Otol Rhinol Laryngol

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The aim of this study was to compare the incidences of extraesophageal reflux in patients with contact granuloma and healthy controls. A 24-hour ambulatory pH monitoring technique was used to measure reflux parameters in the pharynx and distal esophagus. Pharyngeal acid reflux events occurred in 17 of 26 granuloma patients (1 to 20 episodes per patient) and 5 of 19 controls (1 to 8 episodes per subject). The reflux episodes were typically short and occurred predominantly in an upright position. A comparison between the groups showed a significant difference in the number of pharyngeal reflux episodes (p =.009) and in the total time of pH below 4 (p = .006). On the other hand, we found no significant differences in any esophageal reflux parameters, except for the percentage of distal esophageal reflux episodes that reached the pharynx (p = .006). In this study, pharyngeal acid exposure was significantly more prevalent in patients with contact granuloma than in healthy controls.

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“…Concerning laryngeal symptoms, the most well-studied symptom is hoarseness [2,10,14,[16][17][18]. Several previous studies have demonstrated reflux of gastric acid into the pharynx in patients with chronic hoarseness [17]. LPR is known to contribute to posterior acid laryngitis and laryngeal contact ulceration or granuloma formation, laryngeal cancer, chronic hoarseness and pharyngitis.…”

Section: Laryngeal Disordersmentioning

confidence: 99%

“…In contrast to the typical presentation of classic GERD laryngopharyngeal reflux (LPR) often results in atypical manifestations with oral, pharyngeal and pulmonary disorders. Concerning laryngeal symptoms, the most well-studied symptom is hoarseness [2,10,14,[16][17][18]. Several previous studies have demonstrated reflux of gastric acid into the pharynx in patients with chronic hoarseness [17].…”

Section: Laryngeal Disordersmentioning

confidence: 99%

Extra-Esophageal Disorders in Gastroesophageal Reflux Disease

Jaspersen

2004

Dig Dis

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Gastroesophageal reflux disease (GERD) is a common condition that effects about 10% of the adult population comprising a broad spectrum of symptoms and varying degrees of severity and frequency. Extra-esophageal manifestations are increasingly being recognized. Up to 50% of patients with an endoscopically proven or negative esophagitis suffer from symptoms other than heartburn or acid regurgitation such as laryngitis, hoarseness, chronic cough, asthma, or non-cardiac chest pain. The therapy of choice is proton pump inhibitors.

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Esophagopharyngeal distribution of refluxed gastric acid in patients with reflux laryngitis

Cited by 242 publications

References 13 publications

Gastroesophageal reflux disease and vocal disturbances

Gastroesophageal reflux disease and vocal disturbances

Extraesophageal Reflux in Patients with Contact Granuloma: A Prospective Controlled Study

Extra-Esophageal Disorders in Gastroesophageal Reflux Disease

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