A Study of Laryngopharyngeal Reflux Comparing Clinical Features with Endoscopy : Role of pH-metry

Abstract

Introduction: Laryngopharyngeal reflux (LPR), now a known clinical entity is due to back flow of gastric contents into the upper aero-digestive tract (UADT). LPR is present in up to 50 % of patients with voice disorders [1].

Materials and Methods: A total of 50 patients with symptom complex of voice disorders & chronic cough of unexplained origin were investigated at a tertiary care referral hospital with laryngeal endoscopy and 24 hours ambulatory double probe pH-metry to compare the clinical features before and after the treatment.

Result:  A positive clinical endoscopic finding was seen in 74% whereas 80% showed positive acid reflux affecting the pharynx independently and/ or esophagus. Chronic cough of unknown origin (46 %) was the most predominant presenting symptom & posterior laryngeal erythema was the commonest endoscopic finding.

Conclusion: Chronic cough, persistent throat clearance and change of voice require to be investigated for LPR. Reflux Symptom Index (RSI) & Reflux Finding Score (RFS) are sensitive indices. 24 hour pH monitoring is a sensitive test for detecting LPR and is helpful to assess pre & post therapy outcomes. Positive pH probe studies help select patients who will respond to therapy and this avoids unnecessary treatment in other patients.