TY - JOUR
T1 - Esophageal motor function in laryngopharyngeal reflux is superior to that in classic gastroesophageal reflux disease
AU - Postma, Gregory N.
AU - Belafsky, Peter C.
AU - Tomek, Michael S.
AU - Koufman, James A.
PY - 2001
Y1 - 2001
N2 - Laryngopharyngeal reflux (LPR) in otolaryngology patients appears to be different from classic gastroesophageal reflux disease (GERD). In particular, esophagitis and its principal symptom, heartburn, considered the diagnostic sine qua non of GERD, are often absent in LPR. It has therefore been postulated that LPR patients have superior esophageal function. Esophageal acid clearance (EAC) is a measure of the ability of the esophagus to restore neutral pH after reflux events have occurred. It is considered an excellent overall measure of esophageal function. The mean EAC can be calculated from 24-hour pH monitoring data. A comparison of EAC in patients with GERD and LPR has not been previously reported. To compare the EAC of 1) patients with LPR alone, 2) patients with GERD alone, 3) patients with both LPR and GERD, and 4) patients without either LPR or GERD, we studied 200 otolaryngological patients who had undergone 24-hour double-probe (simultaneous pharyngeal and distal esophageal) pH monitoring, 50 in each group. The subgrouping of each patient was determined by previously established pH monitoring criteria. We defined GERD as abnormal esophageal reflux and LPR as abnormal pharyngeal reflux. The patients with GERD had a mean (±SD) EAC of 1.44 ± 1.2 minutes, and those with LPR had a mean EAC of 1.00 ± 1.00 minutes (p <.05). The patients with both GERD and LPR had a mean EAC of 1.53 ± 1.01 minutes. The patients without reflux had a mean EAC of 0.53 ± 0.38 minutes. We conclude that patients with LPR have significantly better EAC than those with GERD. These data suggest that patients with LPR have superior esophageal function. This finding may clarify our understanding of the differences in mechanisms, symptoms, and incidence of esophagitis in patients with LPR and GERD.
AB - Laryngopharyngeal reflux (LPR) in otolaryngology patients appears to be different from classic gastroesophageal reflux disease (GERD). In particular, esophagitis and its principal symptom, heartburn, considered the diagnostic sine qua non of GERD, are often absent in LPR. It has therefore been postulated that LPR patients have superior esophageal function. Esophageal acid clearance (EAC) is a measure of the ability of the esophagus to restore neutral pH after reflux events have occurred. It is considered an excellent overall measure of esophageal function. The mean EAC can be calculated from 24-hour pH monitoring data. A comparison of EAC in patients with GERD and LPR has not been previously reported. To compare the EAC of 1) patients with LPR alone, 2) patients with GERD alone, 3) patients with both LPR and GERD, and 4) patients without either LPR or GERD, we studied 200 otolaryngological patients who had undergone 24-hour double-probe (simultaneous pharyngeal and distal esophageal) pH monitoring, 50 in each group. The subgrouping of each patient was determined by previously established pH monitoring criteria. We defined GERD as abnormal esophageal reflux and LPR as abnormal pharyngeal reflux. The patients with GERD had a mean (±SD) EAC of 1.44 ± 1.2 minutes, and those with LPR had a mean EAC of 1.00 ± 1.00 minutes (p <.05). The patients with both GERD and LPR had a mean EAC of 1.53 ± 1.01 minutes. The patients without reflux had a mean EAC of 0.53 ± 0.38 minutes. We conclude that patients with LPR have significantly better EAC than those with GERD. These data suggest that patients with LPR have superior esophageal function. This finding may clarify our understanding of the differences in mechanisms, symptoms, and incidence of esophagitis in patients with LPR and GERD.
KW - Esophageal acid clearance
KW - Esophagus
KW - Gastroesophageal reflux
KW - Laryngopharyngeal reflux
KW - Reflux
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U2 - 10.1177/000348940111001205
DO - 10.1177/000348940111001205
M3 - Article
C2 - 11768699
AN - SCOPUS:0035211149
SN - 0003-4894
VL - 110
SP - 1114
EP - 1116
JO - Annals of Otology, Rhinology and Laryngology
JF - Annals of Otology, Rhinology and Laryngology
IS - 12
ER -