Laryngopharyngeal Reflux Disease; How to Evaluate
IRFAN IQBAL, Registrar, Deptt. of e.n.t govt. Medical College Srinagar j&k India.
ZARKA AMIN MASOODI, Consultant gen. Medicine.
LATIEF .A. CHIESTI, EX.HEAD DEPTT. ENT.
SHOUKAT .A. KADLA, Head Deptt. Gasteroenterology.
Objective: To study how to evaluate Laryngopharyngeal Reflux(LPR), and to formulate management strategy. Study design: Prospective study. Material and methods: A total of 112 patients were studied and followed for a period of at least six months. The study was conducted under the following headings: (1)establish the diagnosis of LPR by using Reflux Finding Score (RFS ) and Reflux Symptom Index(RSI), (2)establish diagnosis of GERD by history and endoscopy,(3)treat LPR by lifestyle modification and medical management using proton pump inhibitors(PPI) or surgical management. Results: Majority of patients were females (53.3%) and in the age group of 20-50 years.RSI was used to study symptoms and median RSI score was (17).The common symptoms were clearing of throat (97.1%),lump in throat (96.2%),excess throat mucus (93.3%) and heartburn (62.9%).The signs of LPR were studied by using RFS and median RFS was (11) .The common findings were vocal cord edema (97.1%) and erythema (93.3%).Symptoms of GERD were present in less than half of patients (47.6%). EGD was found to be normal in (64.8%). The most common finding on EGD was esophagitis (17.1%) followed by gastritis (14.3%) and hiatus hernia (8.6%). Majority of patients responded to medical management only (96.2%) . RSI improved from a mean score of 17.6% at initiation of treatment to 3.9 at 6 months follow up. RFS improved from a mean score of 11.9 at pre-treatment to (1.7) at 6 months follow up. Symptoms of GERD improved completely in all patients at 4 months only. Conclusion: LPR is common and RFS and RSI were used to evaluate LPR and they were reproducible and effective. GERD was present in less than half of the patients. Medical management using twice daily PPI was effective.
Laryngopharyngeal Reflux, Upper Esophageal Sphingter, Reflux Finding Score, Gastroesophageal Reflux
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