Gastroenterology

Gastroenterology

Volume 109, Issue 5, November 1995, Pages 1575-1582
Gastroenterology

Esophagopharyngeal distribution of refluxed gastric acid in patients with reflux laryngitis

https://doi.org/10.1016/0016-5085(95)90646-0Get rights and content

Abstract

Background & Aims A variety of otolaryngological abnormalities have been attributed to the contact of gastroesophageal refluxate with respective structures of the aerodigestive tract. The aim of this study was to determine and compare the pharyngoesophageal distribution of gastric acid refluxate between patients with proven laryngitis attributed clinically to gastroesophageal reflux and three control groups. Methods An ambulatory 24-hour simultaneous three-site pharyngoesophageal pH monitoring technique was used to measure reflux parameters in the pharynx, proximal esophagus, and distal esophagus. Results Between-group comparison showed no significant difference in the reflux parameters in the distal esophagus between the studied groups. A significantly higher percentage of distal reflux episodes reached the proximal esophagus in the laryngitis group than in the control groups (P < 0.01), and the number of pharyngeal reflux episodes and time of acid exposure were significantly higher in the laryngitis group than in the control groups (P < 0.001). Conclusions Compared with normal controls and patients with gastroesophageal reflux disease, pharyngeal reflux of gastric acid is significantly more prevalent and the ratio of proximal to distal esophageal acid reflux episodes is significantly increased in patients with posterior laryngitis. Simultaneous three-site ambulatory pharyngoesophageal pH monitoring may provide supporting evidence when the diagnosis of reflux-induced aerodigestive tract lesions is considered.

References (22)

  • JR Jindal et al.

    Idiopathic subglottic stenosis and gastroesophageal reflux disease

    Ann Otol Rhinol Laryngol

    (1994)
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    Supported in part by National Institutes of Health grants R01-DC00669 and R01 DK25731, a Merit Review Grant from the Department of Veterans Affairs, and an educational grant from Glaxo Research institute.

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