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Relationship between laryngopharyngeal reflux disease and gastroesophageal reflux disease based on synchronous esophageal and oropharyngeal Dx-pH monitoring
Abstract:PurposeTo use the synchronous esophageal and oropharyngeal Dx-pH monitoring analysis to investigate the relationship between LPRD and GERD.Materials and methodsSynchronous esophageal and oropharyngeal Dx-pH monitoring, electronic gastroscopy, reflux symptom index (RSI) and gastroesophageal reflux questionnaire (Gerd-Q) were collected from 514 consecutive patients and comparative analysis was done.ResultsA total of 85 patients had positive Ryan score and 251 cases had positive DeMeester or acid exposure time percent (AET) ≥4.2%. Moreover, 61.2% (52/85) of all LPRD cases were pure LPRD without GERD. There was no statistical difference in the acid exposure to oropharynx between pure LPRD group and LPRD+GERD group (U test, P > 0.05). Furthermore, there were no statistical differences in the other esophageal reflux data between pure GERD without LPRD group and LPRD+GERD group (U test, P > 0.05) apart from the number of episodes, which was higher in the pure GERD group than in LPRD+GERD group (U test, P = 0.027). Additionally, 149 patients were diagnosed with reflux esophagitis by electronic gastroscopy. No significant difference in the acid exposure to oropharynx was seen between different grades of reflux esophagitis (U test, P > 0.05). Among the LPRD patients, 32 cases (37.6%) were negative for Gerd-Q, Dx-pH esophageal probe and gastroscopy.ConclusionThe results of synchronous esophageal and oropharyngeal Dx-pH monitoring demonstrated that LPRD and GERD could co-exist as separate medical conditions. Our data suggest that some LPRD are not accompanied by GERD, and that LPRD is not secondary to severe GERD.
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