Unbound MEDLINE

The comparison of an empiric proton pump inhibitor trial vs 24-hour double-probe Ph monitoring in laryngopharyngeal reflux. The Journal of laryngology and otology. [J Laryngol Otol] Journal article

 
TitleThe comparison of an empiric proton pump inhibitor trial vs 24-hour double-probe Ph monitoring in laryngopharyngeal reflux.
Author(s)Bilgen C, Ogüt F, Kesimli-Dinç H, Kirazli T, Bor S 
InstitutionDepartment of Otorhinolaryngology, Ege University, Medical School, Izmir, Turkey. cembilgen@hotmail.com
SourceJ Laryngol Otol 2003 May; 117(5):386-90.
MeSHAdult
Aged
Enzyme Inhibitors
Female
Gastroesophageal Reflux
Humans
Hydrogen-Ion Concentration
Larynx
Male
Middle Aged
Monitoring, Ambulatory
Omeprazole
Proton Pumps
Reproducibility of Results
Time Factors
AbstractLaryngopharyngeal reflux (LPR), which is defined as the backflow of gastric contents into the upper aerodigestive tract, is a relatively common disorder. However, its diagnosis still poses many problems. Twenty-four-hour double-probe pH monitoring is currently the diagnostic test of choice, but it has many disadvantages. Thus, an empiric trial of antireflux therapy has been suggested as an alternative method for diagnosis. The purpose of this article is to evaluate the validity of this alternative method in the management of LPR. The study group consisted of 36 patients with symptoms and physical findings suggesting LPR. The control subjects were 23 healthy adults. Twenty-four-hour double-probe pH monitoring was performed both in the study group and the control group, and the results were compared. In addition, the symptoms and physical findings in the study group was scored by the modified reflux symptom index (MRSI) and reflux finding score (RFS) at four intervals: before the start of therapy and at the second, fourth and sixth months of the therapy. The results of the 24-hour double-probe pH monitoring showed no significant difference between the study and the control groups (p>0.05). In the study group, the MRSI before the therapy was 13.6+/-4.4. This index improved significantly to 4.3+/-1.9 at the second month; to 1.5+/-0.6 at the fourth month, and to 0.5+/-0.2 at the sixth month of the therapy (p<0.05). The RFS before the start of the therapy was 14.8+/-3.8; and it improved significantly to 7.7+/-3.8 at the second month; to 4.5+/-2.3 at the fourth month, and to 1.4+/-0.9 at the sixth month of the therapy (p<0.05). The significant improvement in the MRSI and the RFS during the course of proton pump inhibitor therapy relates the patients' symptoms and physical findings to LPR. This implies the validity of the method, not only in the treatment of LPR, but in the diagnosis of this disorder, as well. Unfortunately, 24-hour double-probe pH monitoring has failed to differentiate LPR patients from healthy individuals.
Languageeng
Pub Type(s)Evaluation Studies
Journal Article
PubMed ID12803789
  
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