Distinct Physiological Characteristics of Isolated Laryngopharyngeal Reflux Symptoms

doi:10.1016/j.cgh.2019.08.064

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/24905

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題名:	Distinct Physiological Characteristics of Isolated Laryngopharyngeal Reflux Symptoms
作者:	Lien, HC;Wang, CC;Kao, JY;Yeh, HZ;Hsu, JY;Lee, SW;Chuang, CY;Tsou, YA;Wang, JD;Vaezi, MF;Chang, CS
關鍵詞:	Esophageal Motility;Esophageal Hyposensitivity;Pathophysiology
日期:	2020
上傳時間:	2022-08-09T08:09:54Z (UTC)
出版者:	ELSEVIER SCIENCE INC
ISSN:	1542-3565
摘要:	BACKGROUND & AIMS: Patients with isolated laryngopharyngeal reflux symptoms (LPRS) defined as those without concomitant typical reflux symptoms (CTRS) are clinically challenging to manage due to unclear pathophysiology. We investigated esophageal physiology in patients with isolated LPRS and their response to proton-pump inhibitors (PPI) therapy. METHODS: This is a multi-center observational study conducted in referral hospitals in Taiwan. Patients with predominant LPRS, but without common non-reflux causes, underwent esophageal manometry, 24-hr ambulatory esophagopharyngeal pH testing, and Bernstein test, followed by a 12-week esomeprazole 40 mg twice-daily treatment. Participants with pathological reflux were divided into the isolated LPRS group (ie, LPRS without CTRS, n = 40) and the CTRS group (ie, LPRS with CTRS, n = 66). Participants without pathological reflux or esophagitis (n = 132) served as the nonreflux controls. RESULTS: The PPI-responsiveness was similar between the isolated LPRS group and CTRS group (63% vs 57%, P = .8), but lower in the nonreflux controls (32%, P = .005). Despite similar distal esophageal acid exposure time (P = .7) when compared to those with CTRS, the isolated LPRS group had a lower prevalence of both positive Bernstein test (P = .001) and ineffective esophageal motility disorder (P = .03), and fewer pharyngeal acid reflux episodes (P < .0001). CONCLUSIONS: Our findings indicate similar distal esophageal acid exposure and PPI-responsiveness between LPRS patients with and without CTRS. The lack of CTRS in the isolated LPRS group is likely due to esophageal acid hyposensitivity and fewer pharyngeal acid reflux episodes, thus implicating distinct pathophysiology of isolated LPRS from those with CTRS.
URI:	http://dx.doi.org/10.1016/j.cgh.2019.08.064 https://www.webofscience.com/wos/woscc/full-record/WOS:000552305900020 https://ir.csmu.edu.tw:8080/handle/310902500/24905
關聯:	CLINICAL GASTROENTEROLOGY AND HEPATOLOGY ,2020 ,v18 ,issue 7 ,p1466-+
顯示於類別:	[中山醫學大學研究成果] 期刊論文

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