Laryngopharyngeal reflux might play a role on chronic nonspecific pharyngitis

Abstract

Chronic nonspecific pharyngitis is one of the most common reasons for visits to otorhinolaryngology physicians. The underlying conditions are still unknown. The aim of this study was to investigate the role of laryngopharyngeal reflux in chronic nonspecific pharyngitis patients based on the patient's history and clinical examination. Fifty consecutive patients with symptoms of chronic nonspecific pharyngitis and control group of 30 healthy persons were evaluated prospectively. 14C-urea breath test was used to exclude Helicobacter pylori infection of gastric mucosa. All the patients and the controls were assessed by blinded same laryngologist with the use of the reflux finding score (RFS) and reflux symptoms index (RSI). Also chronic nonspecific pharyngitis patients with laryngopharyngeal reflux (LPR) were evaluated prospectively before and 6 months after b.i.d treatment with proton pump inhibitors. The RSI of the nonspecific pharyngitis group was found significantly higher than the control group (P < 0.01). The RFS of nonspecific pharyngitis was found significantly higher than the control group (P < 0.01). The reflux finding score > or =7 has been accepted as LPR; the reflux incidence was significantly higher in the nonspecific pharyngitis group than the control group (P < 0.01). Posttreatment RSI of nonspecific pharyngitis patients group revealed a statistically significant decrease when compared with the pretreatment RSI (P < 0.01). Posttreatment RFS of nonspecific pharyngitis patients also revealed a significant decrease when compared with the pretreatment RFS (P < 0.01). We suggest that LPR may be related to the pathogenesis of chronic nonspecific pharyngitis.

Clinical evaluation of green tea polyphenols in treatment of pharyngitis in human subjects

“…Other causative factors of pharyngitis have also been recognized like alcohol use and smoking in life style than infection cause (Middleton, 1991;Yazici et al, 2010). Tea and its components have been found protective against pharyneal lesions induced by tobacco (Santhosh et al, 2005;Lee et al, 1997;Tavani et al, 2003) and alcohol (Tavani et al, 2003;Łuczaj and Skrzydlewska, 2004).…”

“…This condition is most often caused by direct infection of the pharynx by various viruses or bacteria (Bisno et al, 2002), among which group A beta-hemolytic streptococcus (GABHS) accounts for about 15 to 30% cases in children and 5 to 15% cases in adults (Bisno et al, 2002;Ruppert, 1996;Matthys et al, 2007). There may also be several other causes of pharyngitis, such as gastroesophageal reflux, persistent cough, thyroiditis, allergies, foreign body, alcohol drinking, and smoking (Yazici et al, 2010;Middleton, 1991) and the condition is thus complicated with increased environmental pollution. *Corresponding author.…”

Ribosomal therapy in patients with pharyngolaryngeal reflux

“…When a patient presents with pharyngitis symptoms, the ENT physician must consider a wide range of illnesses. If patients do not have any other signs of infection, physicians should investigate noninfectious causes such as rhinitis, allergies, and laryngopharyngeal reflux [18].…”

The Patient with Sore Throat

“…Since the 1990s reflux has been considered a contributor to laryngeal irritation, and more recently studies have sought to understand its role in chronic nonspecific pharyngitis. 41 The mucosa of the larynx and pharynx are more sensitive to acid and pepsin than the gastric or esophageal mucosa. The larynx and pharynx lack bicarbonate production and peristalsis, which are protective to the stomach and esophagus.…”

“…Their symptom and finding scores also decreased compared with controls after 2 months of twice-daily proton pump inhibitor (PPI) therapy. 41 There are 3 approaches to confirming the diagnosis of LPR: (1) response of symptoms to behavioral and empiric medical treatment, (2) endoscopic observation of mucosal injury, and (3) demonstration of reflux events by impedance and pHmonitoring studies or barium swallow esophagram. The first approach can be trialed by any primary practitioner.…”