Laryngopharyngeal reflux, gastroesophageal reflux and dental disorders: A systematic review

Lechien, Jérôme R.; Chiesa‐Estomba, Carlos Miguel; Henriquez, Christian Calvo; Mouawad, F.; Ristagno, Cyrielle; Barillari, Maria Rosaria; Schindler, Antonio; Nacci, Andrea; Bouland, Cyril; Laino, Luigi; Saussez, Sven

doi:10.1371/journal.pone.0237581

Cited by 35 publications

(34 citation statements)

References 66 publications

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“…RSS-12 and the identification of these oral and oropharyngeal findings may be both used in primary care medicine for the diagnosis and the evaluation of therapeutic response. The primary care physician has to be aware of the LPR signs and symptoms in children or adults with chronic dental disorders, i.e., decays or erosion, with regards to the potential association between LPR and these common conditions [ 56 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians

Lechien

Saussez

Muls

et al. 2020

JCM

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Laryngopharyngeal reflux (LPR) is a common disease in the general population with acute or chronic symptoms. LPR is often misdiagnosed in primary care because of the lack of typical gastroesophageal reflux disease (GERD) symptoms and findings on endoscopy. Depending on the physician’s specialty and experience, LPR may be over- or under-diagnosed. Management of LPR is potentially entirely feasible in primary care as long as General Practitioners (GPs) are aware of certain “red flags” that will prompt referral to a Gastroenterologist or an Otolaryngologist. The use of patient-reported outcome questionnaires and the consideration of some easy ways to diagnose LPR without special instrumentation oropharyngeal findings may help the GP to diagnose and often manage LPR. In this review, we provide a practical algorithm for LPR management for GPs and other specialists that cannot perform fiberoptic examination. In this algorithm, physicians have to exclude some confounding conditions such as allergy or other causes of pharyngolaryngitis and “red flags”. They may prescribe an empirical treatment based on diet and behavioral changes with or without medication, depending on the symptom severity. Proton pump inhibitors and alginates remain a popular choice in order to protect the upper aerodigestive tract mucosa from acid, weakly acid and alkaline pharyngeal reflux events.

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Section: Resultsmentioning

confidence: 99%

Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians

Lechien

Saussez

Muls

et al. 2020

JCM

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“…Interestingly, we observed that symptoms significantly improved or resolved with an adequate treatment and a long-term antireflux diet. A few studies investigated the involvement of reflux in dental lesions [ 17 ], or primary burning mouth syndrome [ 18 , 19 , 20 ], but authors reported conflicting results, which may be related to methodological discrepancies across studies [ 21 ]. Indeed, the majority of authors studied the association between burning mouth syndrome and reflux considering GERD and not LPR diagnostic criteria [ 18 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Atypical Clinical Presentation of Laryngopharyngeal Reflux: A 5-Year Case Series

Lechien

Hans

Bobin

et al. 2021

JCM

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Background: Laryngopharyngeal reflux (LPR) is a common disease in otolaryngology characterized by an inflammatory reaction of the mucosa of the upper aerodigestive tract caused by digestive refluxate enzymes. LPR has been identified as the etiological or favoring factor of laryngeal, oral, sinonasal, or otological diseases. In this case series, we reported the atypical clinical presentation of LPR in patients presenting in our clinic with reflux. Methods: A retrospective medical chart review of 351 patients with LPR treated in the European Reflux Clinic in Brussels, Poitiers and Paris was performed. In order to be included, patients had to report an atypical clinical presentation of LPR, consisting of symptoms or findings that are not described in the reflux symptom score and reflux sign assessment. The LPR diagnosis was confirmed with a 24 h hypopharyngeal-esophageal impedance pH study, and patients were treated with a combination of diet, proton pump inhibitors, and alginates. The atypical symptoms or findings had to be resolved from pre- to posttreatment. Results: From 2017 to 2021, 21 patients with atypical LPR were treated in our center. The clinical presentation consisted of recurrent aphthosis or burning mouth (N = 9), recurrent burps and abdominal disorders (N = 2), posterior nasal obstruction (N = 2), recurrent acute suppurative otitis media (N = 2), severe vocal fold dysplasia (N = 2), and recurrent acute rhinopharyngitis (N = 1), tearing (N = 1), aspirations (N = 1), or tracheobronchitis (N = 1). Abnormal upper aerodigestive tract reflux events were identified in all of these patients. Atypical clinical findings resolved and did not recur after an adequate antireflux treatment. Conclusion: LPR may present with various clinical presentations, including mouth, eye, tracheobronchial, nasal, or laryngeal findings, which may all regress with adequate treatment. Future studies are needed to better specify the relationship between LPR and these atypical findings through analyses identifying gastroduodenal enzymes in the inflamed tissue.

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“…Interestingly, we observed that symptoms significantly improved or resolved with an adequate treatment and a long-term antireflux diet. A few studies investigated the involvement of reflux in dental lesions [18], or primary burning mouth syndrome [19][20][21] but authors reported conflicting results, which may be related to methodological discrepancies across studies [22]. Indeed, the majority of authors studied the association between burning mouth syndrome and reflux considering GERD and not LPR diagnostic criteria [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Atypical Clinical Presentation of Laryngopharyngeal Reflux: A 5-year Case-Series

Lechien¹,

Hans²,

Bobin³

et al. 2021

Preprint

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Background: Laryngopharyngeal reflux (LPR) is a common disease in otolaryngology characterized by an inflammatory reaction of the mucosa of the upper aerodigestive tract caused by digestive refluxate enzymes. LPR has been identified as etiological or favoring factor of laryngeal, oral, sinonasal or otological diseases. In this case-series, we reported atypical clinical presentation of LPR in patients presenting in our clinic with reflux. Methods: A retrospective medical chart review of 351 patients with LPR treated in the European Reflux Clinic in Brussels, Poitiers and Paris was performed. In order to be included, patients had to report atypical clinical presentation of LPR, consisting of symptoms or findings that are not described in reflux symptom score and reflux sign assessment. The LPR diagnosis was confirmed with 24-hour hypopharyngeal-esophageal impedance pH-study and patients were treated with a combination of diet, proton pump inhibitors and alginates. The atypical symptoms or findings had to be resolved from pre- to posttreatment Results: From 2017 to 2021, 21 patients with atypical LPR were treated in our center. The clinical presentation consisted of recurrent aphthosis or burning mouth (N=9), recurrent burps and abdominal disorders (N=2), posterior nasal obstruction (N=2), recurrent acute suppurative otitis media (N=2), severe vocal fold dysplasia (N=2), and recurrent acute rhinopharyngitis (N=1), tearing (N=1), aspirations (N=1) or tracheobronchitis (N=1). Abnormal upper aerodigestive tract reflux events were identified in all of these patients. Atypical clinical findings resolved and did not recur after an adequate anti-reflux treatment. Conclusion: LPR may present with various clinical presentations including mouth, eye, tracheobronchial, nasal or laryngeal findings, which may all regress with an adequate treatment. Future studies are needed to better specify the relationship between LPR and these atypical findings through analyses identifying gastroduodenal enzyme in the enflamed tissue.

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Laryngopharyngeal reflux, gastroesophageal reflux and dental disorders: A systematic review

Cited by 35 publications

References 66 publications

Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians

Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians

Atypical Clinical Presentation of Laryngopharyngeal Reflux: A 5-Year Case Series

Atypical Clinical Presentation of Laryngopharyngeal Reflux: A 5-year Case-Series

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