[A pilot study on diagnosing laryngopharyngeal reflux disease by pH monitoring in laryngopharynx].
OBJECTIVE
To analyze the significance of pH monitoring and reflux symptom index (RSI) in the diagnosis of laryngopharyngeal reflux disease (LPRD) and the characteristics of LPRD in symptoms and pH monitoring.


METHODS
RSI questionnaire survey and laryngopharyngeal pH monitoring were conducted on. 31 patients with laryngopharyngeal reflux-related symptoms, 15 males aged (50 +/- 13) years and 16 females aged (48 +/- 11) years, Gastroscopy was conducted on 13 patients to detect reflux esophagitis. The patients with the RSI scores > or = 13 were suspected as with LPRD and those with the reflux times > or = 7 or reflux area index (RAI) > or = 6.3 were diagnosed as with LPRD. McNemar test and Kappa test were performed on the RSI scores and reflux area indexes.


RESULTS
Seventeen patients met the pH criteria. There were 8 patients suffering from voice disorders, 17 from clearing throat, 13 from excess throat mucus, 11 from dysphagia, 9 from cough after eating or with supine posture, 9 from dyspnea, 13 from cough, 12 from foreign body sensation, and 14 from digestive symptoms with the foregoing symptoms' mean scores of 1.4, 3.1, 2.1, 2.0, 1.1, 1.6, 1.8, 2.9, and 2.9 respectively. The P value with McNemar test on pH monitoring and RSI scoring was 0.289, and the P value with kappa test was 0.007. RSI was correlated with RAI(r(s) = 0.302, P = 0.049), reflux time (r(s) = 0.454, P = 0.005), and reflux time percentage (r(s) = 0.439, P = 0.007), but not correlated with the reflux frequency (r(s) = 0.252, P = 0.086). Supine reflux was seen in only 7 of the 224 reflux events in 17 patients, lasting only 96 seconds during the 84.6 minutes' supine acid exposure time.


CONCLUSIONS
The common symptoms of LPRD are clearing throat, digestive symptoms, excess throat mucus, and foreign body sensation. Laryngopharyngeal pH monitoring and RSI scoring have the same value in diagnosing LPRD. Acid exposure in laryngopharynx is correlation to patients' self-report symptom. Almost all reflux events occur when the patients are in upright position.
Feng
Gui-Jian
GJ
Department of Gastroenterology, People's Hospital of Peking University, Beijing 100044, China. fggods@126.com
Zhang
Li-Hong
LH
Zhao
Li-Li
LL
Liu
Yu-Lan
YL