Monitoring of laryngopharyngeal reflux: influence of meals and beverages.
Ambulatory 24-hour double-probe pH monitoring seems to be the best test to measure reflux. Artifacts caused by intake of acid foods and beverages have to be excluded, necessitating a time-consuming manual review of the 24-hour data. Dietary restrictions used to bypass these artifacts would interfere with the normal daily life situation. Therefore, the influence of food and beverages ingested during the monitoring period was studied. Data from 252 patients who underwent double-probe pH monitoring were analyzed, first by visual inspection of the 24-hour tracing and second by leaving out the intake periods. As to the registration of gastroesophageal reflux, the inclusion or omission of meals and beverages hardly influenced the data. However, the registration of laryngopharyngeal reflux was severely biased by intake of food and beverages and other artifacts. Leaving out meals and beverages did not correct for all artifacts. Therefore, we recommend review of each laryngopharyngeal pH drop.
Smit
Conrad F
CF
Department of Otorhinolaryngology-Head and Neck Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Mathus-Vliegen
Lisbeth M H
LM
Devriese
Pieter P
PP
van Leeuwen
Justin A M J
JA
Semin
Astrid
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D001628:Beverages / Q000009:adverse effects*; D015982:Bias; D005260:Female; D005502:Food / Q000009:adverse effects*; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007013:Hypopharynx; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D009716:Numerical Analysis, Computer-Assisted; D010608:Pharyngeal Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D016683:Supine Position; D013997:Time Factors