Laryngopharyngeal reflux and GERD

@article{Johnston2013LaryngopharyngealRA,
  title={Laryngopharyngeal reflux and GERD},
  author={Nikki Johnston and Peter William Dettmar and Vicki Strugala and Jacqui Allen and Walter Wai-Yip Chan},
  journal={Annals of the New York Academy of Sciences},
  year={2013},
  volume={1300}
}
In patients with laryngopharygeal reflux (LPR), gastric contents exhibit retrograde flow into the upper aero‐digestive tract, causing extraesophageal symptoms including chronic cough, hoarseness, indigestion, difficulty swallowing, globus pharyngis, and asthma. The following on laryngopharyngeal reflux includes commentaries on the use of patient‐completed questionaires and anti‐human pepsin antibodies and other non‐invasive tests in diagnosis; the role of pepsin and acid in the etiologies of… 

Extra-esophageal GERD: Myth or Reality?

The management of extra-esophageal GERD is often empiric and targeted at specific symptoms, and the initial approach is to use empirical therapy with high-dose proton pump inhibitors (PPIs), and further investigations are required in unresponsive cases.

Reflux and the Voice: Getting Smarter About Laryngopharyngeal Reflux.

The Role of Pepsin in Laryngopharyngeal Reflux

This review focuses on the current studies about pepsin as a specific marker for LPR and putative relationship between pepingin and laryngeal cancer.

Therapeutic trial of proton pump inhibitors for management of patients with laryngopharyngeal reflux

Therapeutic trial seems to be an effective way of initial management of patients with anticipated LPR which can be used after the cause of the problems is ruled out by other specialists.

How many cases of laryngopharyngeal reflux suspected by laryngoscopy are gastroesophageal reflux disease-related?

No differences were found among the three groups of patients in terms of the frequency of laryngeal signs and the differences observed by means of MII-pH analysis among theThree subgroups of patients (ERD/NERD, HE, no GERD) were not demonstrated with the RSI and RFS.

The Role of Pepsin in LPR: Will It Change Our Diagnostic and Therapeutic Approach to the Disease?

Pepsin has been proposed as a novel therapeutic target, especially for patients experiencing refractory symptoms on currently available anti-reflux medications, and Measurement of pepsin in patients with LPR symptoms holds promise as a reliable diagnostic test.

Controlling Bronchial Asthma through the Management ofLaryngopharyngeal Reflux (LPR)

The management of laryngopharyngeal reflux using proton pump inhibitors in patients with uncontrolled asthma can significantly improve their asthma control after eight weeks.

Efficacy evaluation of pepsin in laparoscopic antireflux surgery for gastroesophageal reflux disease.

  • Xiang GaoDiangang Liu Fei Li
  • Medicine
    Technology and health care : official journal of the European Society for Engineering and Medicine
  • 2020
Laroscopic fundoplication and hiatus hernia repair may effectively control the symptoms of GERD and laparoscopy-assisted anti-reflux surgery for GERD because the detection of pepsin is non-invasive and easy to operate.

Patients with chronic rhinosinusitis and simultaneous bronchial asthma suffer from significant extraesophageal reflux

The aim of this study was to determine the severity of extraesophageal reflux (EER) in patients with various degrees of chronic rhinosinusitis (CRS), and particularly in patients with simultaneous

Symptoms classically attributed to laryngopharyngeal reflux correlate poorly with pharyngeal reflux events on multichannel intraluminal impedance testing.

Broad evaluation for competing differential diagnoses and objective reflux monitoring should be considered in patients with suspected LPR symptoms, given the variable symptomatology and response to therapy.

References

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Laryngopharyngeal reflux is different from classic gastroesophageal reflux disease.

The patterns, mechanisms, manifestations, and treatment of laryngopharyngeal reflux (LPR) and gastroesophagealReflux disease (GERD) differ, and the gastroenterology model of reflux disease does not apply to LPR, which is often called silent reflux.

Laryngeal signs and symptoms and gastroesophageal reflux disease (GERD): a critical assessment of cause and effect association.

  • M. VaeziD. HicksT. AbelsonJ. Richter
  • Medicine
    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
  • 2003
The reasons for this controversy are discussed and the recent data attempting to clarify the cause and effect relationship between GERD and ENT are highlighted.

Pepsin detection in patients with laryngopharyngeal reflux before and after fundoplication

Pepsin is often found on laryngeal epithelial biopsy and in sputum of patients with pH-test-proven GERD and symptoms of LPR, and detection of pepsin improves diagnostic accuracy in patients with LPR.

Pepsin promotes proliferation of laryngeal and pharyngeal epithelial cells

The objective of this study was to test the hypothesis that reflux of pepsin into the laryngopharynx can promote carcinogenesis.

Laryngopharyngeal reflux in laryngeal cancer.

Laryngeal cancer patients and patients with heartburn complaints all have a high rate of gastroesophageal reflux, but cancer patients reveal a higher rate of laryngopharyngeAl reflux than the symptomatic patients with normal laryngeAL findings.

Laryngeal carcinoma and laryngo-pharyngeal reflux disease.

Data emerging from this study would seem to support the theory that the protracted exposure to biliary reflux would represent a statistically significant added risk factor in the precancerous lesions and squamous pharyngo-laryngeal carcinoma as it occurs at oesophageal level.

Laryngopharyngeal Reflux Symptoms Improve Before Changes in Physical Findings

Patients with laryngopharyngeal reflux undergoing treatment appear to have improvement in symptoms before the complete resolution of the laryngeAL findings.

Prevalence of Laryngeal Irritation Signs Associated with Reflux in Asymptomatic Volunteers: Impact of Endoscopic Technique (Rigid vs. Flexible Laryngoscope)

This study determined the prevalence of ENT findings in the normal asymptomatic population and compared findings between flexible and rigid laryngoscopes in an attempt to increase specificity of diagnosis of reflux in endoscopic laryngeal examinations.

Duodenal Contents Reflux-Induced Laryngitis in Rats: Possible Mechanism of Enhancement of the Causative Factors in Laryngeal Carcinogenesis

Reflux does not appear to be an independent risk factor for laryngeal carcinogenesis, but it may enhance the acknowledged etiologic risk factors, namely, smoking and alcohol abuse, by promoting cell proliferation.

Reflux Revisited: Advancing the Role of Pepsin

Today, it is recognised reflux reaches beyond the esophagus, where pepsin, not acid, causes damage, and these new insights may lead to the development of novel drugs that dramatically reduce pepinginogen secretion, block the effects of adherent pepin, and give corresponding clinical benefit.