Laryngopharyngeal Reflux Disease and Gastroesophageal Reflux Disease Can Mutually Influence

Xiaoyu Wang; Jinhong Zhang; Jiasen Wang; Zhi Liu; Chun Zhang; Jing Zhao; Shizhen Zou; Xin Ma; Jinrang Li

doi:10.1016/j.jvoice.2022.10.008

Laryngopharyngeal Reflux Disease and Gastroesophageal Reflux Disease Can Mutually Influence

J Voice. 2022 Nov 5:S0892-1997(22)00313-7. doi: 10.1016/j.jvoice.2022.10.008. Online ahead of print.

Authors

Xiaoyu Wang¹, Jinhong Zhang², Jiasen Wang², Zhi Liu¹, Chun Zhang², Jing Zhao², Shizhen Zou², Xin Ma², Jinrang Li³

Affiliations

¹ Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China; Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, Anhui Province, China.
² Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China.
³ Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China; Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, Anhui Province, China. Electronic address: entljr@sina.com.

PMID: 36347736
DOI: 10.1016/j.jvoice.2022.10.008

Abstract

Objective: To investigate the mutually relationship between gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LPRD).

Methods: All included patients completed simultaneous 24-hour hypopharyngeal intraluminal multichannel impedance pH monitoring (24h-MII-pH), Reflux Symptom Index (RSI), and Reflux Finding Score (RFS). The LPRD diagnosis was based on the occurrence of ≥1 acid or non-acid hypopharyngeal proximal reflux episode(HRE), GERD was defined as a length of time >4.0% of the 24-hour recording spent below pH 4.0 or a DeMeester score >14.72. Patients with both positive LPRD and GERD were classified as LPRD & GERD group, patients with positive LPRD and negative GERD were classified as ILPRD group, patients with negative LPRD and positive GERD were classified as IGERD group, and patients with both negative LPRD and GERD were classified as N group. The differences in clinical characteristics of reflux between the groups were statistically analyzed.

Results: A total of 437 patients were included, including 248 (56.75%) in the ILPRD group, 98 (22.43%) in the LPRD & GERD group, 23 (5.26%) in the IGERD group, and 68 (15.56%) in the N group. There was no significant difference between the types of gastroesophageal reflux in patients with GERD. The number of weak acid/acid/gas/liquid HREs was significantly more in LPRD & GERD patients than in ILPRD patients (P < 0.01), and the number of distal acid reflux events and Longest distal acid clearance time were significantly higher in LPRD & GERD patients than in IGERD patients (P > 0.01).

Conclusion: GERD and LPRD are not the same disease but can mutually influence. Combined GERD increased all types of laryngopharyngeal reflux events in patients with LPRD, whereas combined LPRD only increased acidic distal reflux events and acid clearance time in patients with GERD.

Keywords: Laryngopharyngeal reflux—Gastroesophageal reflux—24h-MII-pH monitoring—Mutually influence.