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Should patients with pH-documented laryngopharyngeal reflux routinely undergo oesophagogastroduodenoscopy? A retrospective analysis

Published online by Cambridge University Press:  12 October 2007

O Reichel*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig Maximilians University Munich, Germany
W J Issing
Affiliation:
Department of Otolaryngology, The Freeman Hospital, Newcastle Upon Tyne, UK
*
Address for correspondence: Dr Oliver Reichel, Department of Otolaryngology, Head and Neck Surgery, Ludwig Maximilians University Munich, University Hospital Grosshadern, Marchioninistr 15, 81377 Munich, Germany. Fax: +49 89 70 95 68 69 E-mail: [email protected]

Abstract

Objectives:

Patients with laryngopharyngeal reflux uncommonly suffer from conditions associated with gastroesophageal reflux disease. However, in some laryngopharyngeal reflux patients, oesophagitis and Barrett's metaplasia can be diagnosed by oesophagogastroduodenoscopy. However, it is unclear which patients with laryngopharyngeal reflux would benefit from routine oesophagogastroduodenoscopy.

Study design:

Retrospective analysis.

Materials and methods:

Analysis of the results of oesophagogastroduodenoscopy in 28 patients with pH-documented laryngopharyngeal reflux.

Results:

Oesophagogastroduodenoscopy showed oesophagitis in five patients (four with grade A, one with grade B), hiatus hernia in 10 patients (36 per cent), Barrett's metaplasia in two patients, Helicobacter pylori-associated chronic gastritis in two patients and gastric mucosal erosions in seven patients (25 per cent). In 13 patients, no abnormalities were detected (46 per cent). Barrett's metaplasia or grade B oesophagitis was diagnosed only in patients with heartburn as their main presenting symptom.

Conclusions:

Oesophagogastroduodenoscopy is indicated in at least those laryngopharyngeal reflux patients reporting heartburn as their main complaint.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Koufman, JA, Aviv, JE, Casiano, RR, Shaw, GY. Laryngopharyngeal reflux: position statement of the Committee on Speech, Voice, and Swallowing Disorders of the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngol Head Neck Surg 2002;127:32–5CrossRefGoogle Scholar
2 Labenz, J. Consequences of Helicobacter pylori cure in ulcer patients. Baillieres Best Pract Res Clin Gastroenterol 2000;14:133–45CrossRefGoogle ScholarPubMed
3 Van Soest, EM, Dieleman, JP, Siersema, PD, Sturkenboom, MCJM, Kuipers, EJ. Increasing incidence of Barrett's oesophagus in the general population. Gut 2005;54:1062–6CrossRefGoogle ScholarPubMed
4 Reavis, KM, Morris, CD, Gopal, DV, Hunter, JG, Jobe, BA. Laryngopharyngeal reflux symptoms better predict the presence of esophageal adenocarcinoma than typical gastroesophageal reflux symptoms. Ann Surg 2004;239:849–58CrossRefGoogle ScholarPubMed
5 Belafsky, PC, Postma, GN, Koufman, JA. Validity and reliability of the reflux symptom index (RSI). J Voice 2002;16:274–7CrossRefGoogle ScholarPubMed
6 Belafsky, PC, Postma, GN, Koufman, JA. The validity and reliability of the reflux finding score (RFS). Laryngoscope 2001;111:1313–17CrossRefGoogle ScholarPubMed
7 Vincent, DA Jr, Garrett, D, Radionoff, SL, Reussner, LA, Stasney, CR. The proximal probe in esophageal pH monitoring: development of a normative database. J Voice 2000;14:247–54CrossRefGoogle ScholarPubMed
8 El-Serag, HB, Sonnenberg, A. Opposing times trends of peptic ulcer and reflux disease. Gut 1998;43:327–33CrossRefGoogle ScholarPubMed
9 DeVault, KR, Castell, DO. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. The Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1999;94:1434–42CrossRefGoogle ScholarPubMed
10 Byrne, PJ, Power, C, Lawlor, P, Ravi, N, Reynolds, JV. Laryngopharyngeal reflux in patients with symptoms of gastroesophageal reflux disease. Dis Esophagus 2006;19:377–81CrossRefGoogle ScholarPubMed
11 Halum, SL, Postma, GN, Bates, DD, Koufman, JA. Incongruence between histologic and endoscopic diagnoses of Barrett's esophagus using transnasal esophagoscopy. Laryngoscope 2006;116:303–6CrossRefGoogle ScholarPubMed
12 Coppola, D, Karl, RC. Barrett's esophagus and Barrett's associated neoplasia: etiology and pathologic features. Cancer Control 1999;6:21–7CrossRefGoogle ScholarPubMed
13 Koufman, JA, Belafsky, PC, Bach, KK, Daniel, E, Postma, GN. Prevalence of esophagitis in patients with pH-documented laryngopharyngeal reflux. Laryngoscope 2002;112:1606–9CrossRefGoogle ScholarPubMed
14 Peek, RM. Helicobacter pylori and gastroesophageal reflux disease. Curr Treat Options Gastroenterol 2004;7:5970CrossRefGoogle ScholarPubMed
15 Kuipers, EJ, Nelis, GF, Klinkenberg-Knol, EC, Snel, P, Goldfain, D, Kolkman, JJ et al. Cure of Helicobacter pylori infection in patients with reflux oesophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial. Gut 2004;53:1220CrossRefGoogle ScholarPubMed
16 Malfertheiner, P, Megraud, F, O'Morain, C, Bazzoli, F et al. . Current C´oncepts in the management of Helicobacter pylori infection´: the Maastricht III Consensus Report. Gut 2007;56:772–81CrossRefGoogle ScholarPubMed
17 Vaezi, MF. Reflux-induced laryngitis (laryngopharyngeal reflux). Curr Treat Options Gastroenterol 2006;9:6974CrossRefGoogle ScholarPubMed
18 Ercan, I, Cakir, , Uzel, TS, Sakiz, D, Karaca, C, Turgut, S. The role of gastric Helicobacter pylori infection in laryngopharyngeal reflux disease. Otolaryngol Head Neck Surg 2006;135:52–5CrossRefGoogle ScholarPubMed
19 Oridate, N, Takeda, H, Yamamoto, J. Helicobacter pylori seropositivity predicts outcomes of acid suppression therapy for laryngopharyngeal reflux symptoms. Laryngoscope 2006;116:547–53CrossRefGoogle ScholarPubMed
20 Loffeld, RJ. H. pylori and reflux esophagitis in Turkish patients living in the Zaanstreek region in the Netherlands. Dig Dis Sci 2003;48:1846–9CrossRefGoogle ScholarPubMed
21 Wright, RA, Hurwitz, AL. Relationship of hiatal hernia to endoscopy proven esophagitis. Dig Dis Sci 1979;24:311–14CrossRefGoogle Scholar
22 Cronstedt, J, Carling, L, Vestergaard, P, Berglund, J. Oesophageal disease revealed by endoscopy in 1,000 patients referred primarily for gastroscopy. Acta Med Scand 1978;204:413–16CrossRefGoogle Scholar
23 Gordon, C, Kang, JY, Neild, PJ, Maxwell, JD. Review article: the role of the hiatus hernia in gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2004;20:719–32CrossRefGoogle ScholarPubMed
24 Cameron, AJ. Barrett's esophagus: prevalence and size of hiatal hernia. Am J Gastroenterol 1999;94:2054–9CrossRefGoogle ScholarPubMed
25 Lehmann, FS, Renner, EL, Meyer-Wyss, B, Wilder-Smith, CH, Mazzucchelli, L, Ruchiti, C et al. Helicobacter pylori and gastric erosions. Result of prevalence study in asymptomatic volunteers. Digestion 2000;62:82–6CrossRefGoogle ScholarPubMed
26 Toljamo, KT, Niemelä, SE, Karttunen, TJ, Karvonen, AL, Lehtola, JK. Clinical significance and outcome of gastric mucosal erosions: a long-term follow-up study. Dig Dis Sci 2006;51:543–7CrossRefGoogle ScholarPubMed
27 Galmiche, JP, Stephenson, K. Treatment of gastroesophageal reflux disease in adults: an individualized approach. Dig Dis 2004;22:148–60CrossRefGoogle ScholarPubMed
28 Vaezi, MF. Sensitivity and specificity of reflux-attributed laryngeal lesions: experimental and clinical evidence. Am J Med 2003;18(suppl 3A):97104SCrossRefGoogle Scholar