An evaluation of olfactory function in adults with gastro-esophageal reflux disease

Conclusion: To the best of the authors’ knowledge, this study is the first to evaluate the olfactory function of adult patients diagnosed with GERD. The results revealed that adults with GERD have diminished olfactory function. Objective: This study aimed to evaluate the olfactory abilities of subjects using the ‘Sniffin’ Sticks’ olfactory test. Methods: A total of 35 men and women aged 18–60 years with a diagnosis of GERD and 45 healthy controls were included in the study. The Sniffin’ Sticks olfactory test results of the two groups were compared, and the relationship between the study findings and the olfactory parameters was evaluated. Results: The odor threshold (10.1; 9.5, p?=?0.016), odor identification (9.6; 8.1, p?p?相似文献   

The value of a liquid alginate suspension (Gaviscon Advance) in the management of laryngopharyngeal reflux

Laryngopharyngeal reflux (LPR) refers to the backflow of stomach contents into the laryngopharynx. Increasing evidence has demonstrated that LPR is a contributing factor in some cases of hoarseness, vocal fatigue, voice breaks, cough and globus and chronic throat clearing. However, several randomised placebo-controlled trials of proton pump inhibitors in the treatment of LPR have been reported with the majority showing no significant benefit in patient symptom scores over placebo. The aim of this pilot clinical study was to investigate whether any improvement in LPR-related symptoms, using the Reflux Symptom Index (RSI), and clinical findings, using the Reflux Finding Score (RFS), could be achieved with treatment with a liquid alginate suspension compared to control (no treatment). Patients presenting with the symptoms of LPR to the Otorhinolaryngology Outpatient Department at the Queen’s Medical Centre, Nottingham, UK were considered eligible if they had an RSI of greater than 10 and an RFS greater than 5 based on a fibreoptic examination of the larynx. A total of 49 patients were randomised into the open, parallel group study; 24 patients were randomised to receive 10 ml liquid alginate suspension (Gaviscon^® Advance) four times daily after meals and at bedtime, and 25 patients into the control group (no treatment). Patients were assessed pre-treatment and at 2, 4 and 6 months post treatment. Mean (SD) RSI and RFS pre-treatment scores were 23.9 (7.0) and 10.4 (3.6) for the treatment group and 24.6 (7.4) and 10.3 (3.3) for the control group, respectively. Significant differences between treatment and control were observed for RSI at the 2-month (11.2 (7.0) vs. 16.8 (6.4), P = 0.005) and 6-month (11.2 (8.1) vs. 18.3 (9.4), P = 0.008) assessments and for RFS at the 6-month (7.1 (2.8) vs. 9.5 (3.4), P = 0.005) assessment. Significant improvement in symptom scores and clinical findings were achieved with liquid alginate suspension (Gaviscon^® Advance) compared to control and further evaluation for the management of patients presenting with LPR is warranted.     

Pachydermia is not diagnostic of active laryngopharyngeal reflux disease

OBJECTIVE: To determine the change in pachydermia/posterior commissure hypertrophy in patients with laryngopharyngeal reflux disease (LPR) on long-term acid-suppressive therapy. STUDY DESIGN: Retrospective chart review. METHODS: Seventeen patients with LPR who were compliant with long-term acid-suppressive treatment and had good control of their symptoms for at least 20 months were examined. Pre- and posttreatment still laryngeal images from these patients were analyzed by five otolaryngologists blinded to patient information and were scored for pachydermia/posterior commissure hypertrophy according to the Reflux Finding Score (RFS) subset. Test-retest intraobserver reliability, intergrader correlations, as well as a paired t test for means of the data sets were then calculated. RESULTS: There was no significant difference in the grading scores between the pre- and posttreatment group for degree of pachydermia/posterior commissure hypertrophy despite a prolonged treatment interval (mean = 32 months) (P = .25). CONCLUSIONS: There is no statistically significant difference in the degree of pachydermia/posterior commissure hypertrophy found at diagnosis and after long-term acid suppressive therapy in patients with LPR. Therefore, it appears that pachydermia, as an isolated finding, is unreliable in determining the presence of active LPR.     

Laryngopharyngeal reflux finding scores correlate with gastroesophageal reflux disease and Helicobacter pylori expression

Conclusion. The expression of Helicobacter pylori (HP) positivity and degree of gastroesophageal reflux disease (GERD) correlate with laryngopharyngeal reflux (LPR). HP positivity and degree of GERD were more adverse in patients with a reflux finding score (RFS) of 7 or more. Objective. We aimed to investigate the relationship between RFS and inflammation of the lower part of the esophagus as well as RFS and HP infection. Patients and methods. Forty-five consecutive patients were analyzed prospectively. The degree of LPR was evaluated using the RFS method. The degree of GERD, lower esophageal mucosal inflammation, and antral HP positivity were evaluated using endoscopic surveys. Results. The mean RFS of the whole population was 11.5±4.4. The mean RFS of patients who had lower esophageal mucosal inflammation was 7±0.1, 8.1±1.3, 13.9±3.7, and 16.6±3.5, for grades A, B, C and D, respectively. The RFS of patients according to HP expression was as follows: 7.2±0.4, 9.3±3.07, 12.7±3.16, and 17.8±2.1, for normal (score 0), score I, score II, and score III, respectively.     

反流性咽喉炎与胃食管反流病的关系研究

目的 :探讨反流性咽喉炎与胃食管反流病 (GRED)发生的关系。方法 :对 130例顽固的慢性咽喉炎患者行胃镜检查或 2 4h食管 pH监测 ,将检测的GRED随机分为两组 ,治疗组 :应用抑胃酸药、促动力药和清热解毒治疗 ;对照组 :单用清热解毒的咽喉炎药 ,对两组咽喉部症状缓解及内镜下病理改善情况进行统计学比较。结果 :检出GRED 45例 (34 .6 % ) ,反流性咽喉炎的体征多样化 ,治疗组 2 3例 ,有效率 91.3% (2 1例 ) ,对照组 2 2例 ,有效率 13.6 % (3例 ) ,P <0 .0 1。结论 :GRED是导致反流性咽喉炎的重要病因 ,抑酸剂与促动力药、清热解毒药合用 ,可缓解或改善反流性咽喉炎的症状和病理。     

Association of gastroesophageal reflux disease and laryngeal cancer

ObjectiveStudies examining the association of reflux disease with the risk of developing laryngeal cancer have both proven and disproven the null hypothesis.MethodsThis retrospective case–control study examines the association of reflux in two populations exposed to similar risk factors, including tobacco, to the extent that end-organ malignant transformation has occurred. After IRB approval was obtained, a search of our hospital's cancer center's database was performed from 2000 to 2013. A retrospective chart review was then performed and the prevalence of gastroesophageal reflux disease among patients with laryngeal cancer (n = 290) was determined. It was then compared to the prevalence of gastroesophageal reflux disease among patients presenting with lung cancer (n = 2440) during the same time period. A multivariate logistic regression was performed to determine the association of reflux with laryngeal cancer.ResultsTaking into consideration tobacco use, there was a strong association between male gender and occurrence of laryngeal cancer as opposed to lung cancer (OR = 3.30; 95% CI 2.53–4.36, P < 0.001). There was a modest association between reflux and laryngeal cancer (OR = 1.65; 95% CI 1.19–2.25, P = 0.003). However, there was no association between reflux and the propensity for carcinoma in specific laryngeal subsites (P = 0.47).ConclusionsIn this study examining a heterogeneous population with end-organ malignancy there was a modest association between reflux and laryngeal cancer. Further research is necessary to determine the biologic relevance of this finding.     

儿童咽喉反流性疾病研究进展

咽喉反流性疾病（1aryngopharyngeal reflux disease,LPRD）是指胃内容物反流至食管上括约肌以上部位,流至咽喉部,与呼吸道和消化道上部组织接触,引起一系列症状和体征的总称。据国外研究表明到耳鼻咽喉科就诊的门诊患者约10%患有LPRD。虽然最近几年,耳鼻咽喉科医师逐渐在重视LPRD的诊疗,但LPRD目前仍是一个不明确的疾病,我们对其真实的发病率及重要性知之甚少,尤其在儿童中LPRD的评估仍存在争议。目前仍有许多工作亟待开展。     

Gastroesophageal reflux disease (GERD), extraesophageal reflux (EER) and recurrent chronic rhinosinusitis

Chronic polypoid rhinosinusitis (CRS) is a common disease, affecting approximately 16% of the adult population in the US every year. In addition to many well known predisposing factors, an association with reflux disease is hypothesized. Such an association might explain the recurrence of polyposis in the face of improved surgical techniques and postsurgical treatment of CRS. At present it is unclear whether extraesophageal reflux directly injures the sinus mucosa, whether gastroesophageal reflux leads to vagus-mediated neuroinflammatory changes, or whether both mechanisms occur separately or simultaneously. In patients suffering from recurrent CRS (n=20) and healthy volunteers (n=20), ambulatory 24 h two channel pH testing was performed. The number of reflux events, the fraction of the total time during which pH was below 4, and the reflux area index (RAI) were determined in the esophagus as well as in the hypopharynx. Patients with recurrent CRS had significantly more reflux events in the esophagus and the fraction of pH<4 and the RAI were increased up to 10-fold compared to healthy volunteers. In contrast to the esophagus, these differences were not observed in the hypopharynx. Recurrent CRS is often associated with GERD but not with EER. Recurrent disease or prolonged recovery after surgery should raise the suspicion of reflux disease as a possible triggering factor. Because GERD itself cannot be diagnosed by laryngoscopy, and because of the subjectivity of symptoms such as heartburn, the otolaryngologist should consider double-probe pH testing as the diagnostic procedure of choice.     

Monitoring of gastric acid suppression in patients with extraesophageal reflux disease

OBJECTIVE: Response to acid suppressive therapy varies in patients with extraesophageal esophageal reflux disease (EERD). Inadequate suppression of gastric acid may contribute to the observed differences in the response to the treatment. The aim of this study was to evaluate suppression of gastric acid in EERD patients being treated with acid suppressive therapy. METHODS: Charts of patients with EERD who underwent dual channel 24h esophageal pH monitoring while receiving acid suppressive therapy between January 2002 and June 2004 were reviewed. Suppression of gastric acid was determined based on the number of acid reflux episodes, esophageal acid exposure, and acid clearance time. RESULTS: Twenty patients (12 male, 8 female, age range: 2-19 years) were identified. Esophageal pH monitoring was within normal limits, documenting complete acid suppression in nine patients (45%). Increased numbers of acid reflux episodes were observed in seven patients. In four patients, the number of acid reflux episodes was normal in spite of incomplete acid suppression. However, other abnormal pH monitoring parameters included delayed acid clearance in three patients and increased acid exposure time in three. The majority of patients also showed alkaline reflux. CONCLUSION: Esophageal pH monitoring documented incomplete acid suppression in this group of infants, children, adolescents and teens with EERD. Monitoring of gastric acid suppression can be useful in guiding the follow-up of EERD patients who receive acid suppressive therapy.     

胃蛋白酶在咽喉反流疾病诊断中的应用

咽喉反流性疾病是近年来被临床医师逐渐认识并引起重视的一种疾病。美国耳鼻咽喉头颈外科学会将其定义为胃内H+和胃蛋白酶原经食管到达咽、喉、鼻、中耳、气管和支气管等部位所引起的临床症候群。随着逐渐深入的研究,学者对胃蛋白酶在咽喉反流病中的作用的认识逐渐提高,认为胃蛋白酶可以作为一种检测方法诊断咽喉反流病。     

口咽、食管同步Dx-pH检测研究咽喉反流性疾病

采用口咽、食管同步Dx-pH检测探讨咽喉反流性疾病（LPRD）与胃食管反流病（GERD）的关系。