Pharyngeal pH measurements in patients with respiratory symptoms before and during proton pump inhibitor therapy.
BACKGROUND
Pharyngeal pH monitoring is a diagnostic tool used to identify Gastroesophageal reflux disease (GERD) as an etiology of respiratory symptoms. We performed pharyngeal pH monitoring on 14 patients with respiratory symptoms thought to be induced by GERD.


METHODS
Symptoms and pH monitoring (esophageal and pharyngeal) were assessed prior to and 3 months after the initiation of double-dose proton pump inhibitor therapy.


RESULTS
Symptoms included cough, hoarseness, and throat clearing. Ten patients had at least one episode of pharyngeal reflux (PR+) and 4 patients had no pharyngeal reflux (PR-). Pharyngeal reflux episodes in PR+ patients decreased from 3.5 to 0.9 (P <0.05) per day with 8 of 10 (80%) patients having elimination or reduction of such episodes. Eight of 9 PR+ patients (89%) with suppressed pharyngeal reflux on medical therapy had resolution of respiratory symptoms. Three of 4 PR- patients (75%) had persistent symptoms on medical therapy.


CONCLUSIONS
Proton pump inhibitor therapy improves clinical symptoms and decreases pharyngeal reflux episodes in patients with respiratory symptoms related to GERD. Direct measurement of pharyngeal pH is helpful in the identification of patients likely to respond to antireflux therapy.
Eubanks
T R
TR
Department of Surgery, University of Washington Medical Center, 1959 NE Pacific Street, Box 356410, Seattle, WA 98195, USA. eubanks@u.washington.edu
Omelanczuk
P
P
Hillel
A
A
Maronian
N
N
Pope
C E
CE
Pellegrini
C A
CA
D000897:Anti-Ulcer Agents / Q000494:pharmacology*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000209:etiology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010614:Pharynx / Q000502:physiology*; D011379:Prognosis; D054328:Proton Pump Inhibitors; D012120:Respiration Disorders / Q000188:drug therapy* / Q000209:etiology
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors