PMID- 30430298
OWN - NLM
STAT- MEDLINE
DCOM- 20190919
LR  - 20231205
IS  - 1573-2568 (Electronic)
IS  - 0163-2116 (Print)
IS  - 0163-2116 (Linking)
VI  - 64
IP  - 5
DP  - 2019 May
TI  - Acidic Pharyngeal Reflux Does Not Correlate with Symptoms and Laryngeal Injury 
      Attributed to Laryngopharyngeal Reflux.
PG  - 1270-1280
LID - 10.1007/s10620-018-5372-1 [doi]
AB  - BACKGROUND: Laryngopharyngeal reflux (LPR) is suspected when the symptoms are 
      attributed to the penetration of acidic gastroesophageal reflux (GER) into the 
      larynx. However, the relationships between the intensity of LPR and symptoms and 
      laryngeal injury have not been elucidated. Several factors confound the study of 
      LPR, namely pH is monitored in the pharynx (pharyngeal reflux) but the pharyngeal 
      acidity (pH) required to induce laryngeal injury is unknown, the GER origin of 
      pharyngeal acid is not always established, and a recent treatment with proton 
      pump inhibitors (PPI) confounds the analysis. AIMS: We aimed to limit these 
      confounding factors to analyze the relationship between LPR and symptoms and 
      laryngeal injury. METHODS: We used dual pharyngeal and distal esophageal 24-h 
      pH/impedance monitoring to establish GER origin of pharyngeal reflux, we used an 
      unbiased approach to analysis by evaluating a whole range of acidity (pH < 6, 
      pH < 5.5, pH < 5.0, pH < 4.5 and pH < 4.0) in patients with suspected LPR without 
      PPI for  > 30 days. RESULTS: Pharyngeal reflux was (median[IQR]) 14[8-20.5] and 
      4[1.5-6.5] pharyngeal reflux episodes with pH < 6.0 and pH < 5.5, respectively. 
      Pharyngeal reflux with pH < 5.0 was rare. Comprehensive analysis did not reveal 
      any correlation between symptoms (reflux symptom index) or laryngeal injury 
      (reflux finding score) and the number of pharyngeal reflux episodes or duration 
      of pharyngeal acid exposure at any pH level. CONCLUSION: Unbiased comprehensive 
      approach did not reveal any relationship between acidic pharyngeal reflux and the 
      symptoms or laryngeal injury attributed to LPR. Limited clinical usefulness of 
      pharyngeal monitoring reported by others is unlikely due to confounding factors.
FAU - Duricek, Martin
AU  - Duricek M
AD  - Gastroenterology Clinic JFM CU, Jessenius Faculty of Medicine in Martin (JFM CU), 
      Comenius University in Bratislava, Kollarova 2, 03659, Martin, Slovakia.
FAU - Banovcin, Peter
AU  - Banovcin P
AD  - Gastroenterology Clinic JFM CU, Jessenius Faculty of Medicine in Martin (JFM CU), 
      Comenius University in Bratislava, Kollarova 2, 03659, Martin, Slovakia. 
      pbanovcin@gmail.com.
FAU - Halickova, Tatiana
AU  - Halickova T
AD  - Clinic of ENT and Head and Neck Surgery, Central Military and Faculty Hospital in 
      Ruzomberok, Povazska 1380/2, 034 01, Ruzomberok, Slovakia.
FAU - Hyrdel, Rudolf
AU  - Hyrdel R
AD  - Gastroenterology Clinic JFM CU, Jessenius Faculty of Medicine in Martin (JFM CU), 
      Comenius University in Bratislava, Kollarova 2, 03659, Martin, Slovakia.
FAU - Kollarik, Marian
AU  - Kollarik M
AD  - Department of Pathophysiology JFM CU, Jessenius Faculty of Medicine in Martin 
      (JFM CU), Comenius University in Bratislava, Ruzomberok, Slovakia.
AD  - Department of Molecular Pharmacology & Physiology, University of South Florida, 
      Tampa, FL, USA.
LA  - eng
GR  - R01 DK110366/DK/NIDDK NIH HHS/United States
GR  - R01 DK110366/NH/NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20181114
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
SB  - IM
CIN - Dig Dis Sci. 2019 May;64(5):1070-1071. PMID: 30684077
MH  - Adult
MH  - Female
MH  - Gastroesophageal Reflux/diagnosis/physiopathology
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Laryngopharyngeal Reflux/*diagnosis/*physiopathology
MH  - Larynx/*injuries/*physiology
MH  - Male
MH  - Middle Aged
MH  - Pharynx/*physiology
MH  - Prospective Studies
PMC - PMC10694844
MID - NIHMS1945414
OTO - NOTNLM
OT  - Acid
OT  - Gastroesophageal reflux
OT  - Laryngopharyngeal reflux
OT  - Reflux finding score
OT  - pH-impedance monitoring
COIS- Conflict of interest The authors declare that they have no conflict of interest.
EDAT- 2018/11/16 06:00
MHDA- 2019/09/20 06:00
PMCR- 2023/12/04
CRDT- 2018/11/16 06:00
PHST- 2018/03/28 00:00 [received]
PHST- 2018/11/08 00:00 [accepted]
PHST- 2018/11/16 06:00 [pubmed]
PHST- 2019/09/20 06:00 [medline]
PHST- 2018/11/16 06:00 [entrez]
PHST- 2023/12/04 00:00 [pmc-release]
AID - 10.1007/s10620-018-5372-1 [pii]
AID - 10.1007/s10620-018-5372-1 [doi]
PST - ppublish
SO  - Dig Dis Sci. 2019 May;64(5):1270-1280. doi: 10.1007/s10620-018-5372-1. Epub 2018 
      Nov 14.