Esophagopharyngeal reflux.
OBJECTIVE
Laryngopharyngeal reflux (LPR) is the disorder caused by the regurgitation of gastric contents into the laryngopharynx. Many persons diagnosed with LPR who fail medical therapy regurgitate contents from the proximal esophagus into the laryngopharynx (esophagopharyngeal reflux or EPR) on cinefluoroscopy.


METHODS
Retrospective review.


METHODS
The charts of consecutive adult patients with findings of EPR on cinefluoroscopy were reviewed.


RESULTS
Twenty patients met the diagnostic criteria for EPR (mean age, 50 years of age; 60% female). Most common symptoms were cough (40%), dysphagia (35%), dysphonia (25%), and chronic throat clearing (25%). Eighty-five percent had a prior diagnosis of acid reflux disease (LPR or GER) and were unsuccessfully treated with proton pump inhibitors and/or anti-reflux surgery; 15% had fluoroscopic oropharyngeal abnormalities; all patients had fluoroscopic esophageal abnormalities.


CONCLUSIONS
EPR is characterized by regurgitation of proximal esophageal contents into the laryngopharynx. The symptoms are similar to LPR. EPR appears to be caused by a disorder of volume clearance and esophageal dysmotility not acid and peptic injury.
Belafsky
Peter C
PC
The Center for Voice and Swallowing, University of California-Davis, Department of Otolaryngology-Head and Neck Surgery, Sacramento, CA 95817, USA. peterb@ucdvoice.org
Rees
Catherine J
CJ
Rodriguez
Kimsey
K
Pryor
Jan S
JS
Katz
Philip O
PO
D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use; D002404:Catheterization / Q000379:methods; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D050782:Esophageal pH Monitoring; D004947:Esophagus / Q000000981:diagnostic imaging*; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index
D000932:Antiemetics; D054328:Proton Pump Inhibitors