Eckley Claudia Alessandra, Costa Henrique Olival
School of Medical Sciences of the Santa Casa de SP, Brazil.
Braz J Otorhinolaryngol. 2006 Jan-Feb;72(1):55-60. doi: 10.1016/s1808-8694(15)30035-5.
Gastroesophageal Reflux Disease (GERD) is the most prevalent digestive disease of the modern society and has been associated with abnormalities in the larynx and pharynx (LPR). Nonetheless, little is known about the mechanisms involved in this atypical form of the disease. Contradictory clinical data suggest a defense deficit at this segment. Saliva with its organic and inorganic components is responsible for the homeostasis of the oral mucosa and the digestive tract. Salivary pH and volume abnormalities have been linked to laryngopharyngeal symptoms of GERD and LPR. In a recent study we demonstrated significant salivary pH reduction in patients with LPR. Another study found correlation between reduced salivary pH and volume directly related to esophageal pH-metry results.
To evaluate salivary pH and volume before and after clinical treatment of LPR.
Twenty-three adults with LPR had total fasting saliva tested before and after a 12-week course of oral proton pump inhibitor.
A statistically significant difference was found in salivary pH before and after treatment with increase of pH values after control of the disease (p<0.001). Salivary volumes of treated patients were also significantly higher than in pre-treated patients (p=0.009).
These findings suggest that salivary pH and volume are influenced by the presence of gastroesophageal contents and that salivary pH monitoring can potentially become a cost-effective method for diagnosing and controlling LPR.
胃食管反流病(GERD)是现代社会中最常见的消化系统疾病,并且与喉和咽的异常(LPR)有关。然而,对于这种非典型疾病形式所涉及的机制知之甚少。相互矛盾的临床数据表明该部位存在防御缺陷。含有有机和无机成分的唾液负责口腔黏膜和消化道的内环境稳定。唾液pH值和体积异常与GERD和LPR的喉咽症状有关。在最近的一项研究中,我们证明了LPR患者唾液pH值显著降低。另一项研究发现唾液pH值降低与体积减少之间的相关性与食管pH测量结果直接相关。
评估LPR临床治疗前后的唾液pH值和体积。
23名LPR成年患者在口服质子泵抑制剂12周疗程前后进行了空腹全唾液检测。
治疗前后唾液pH值存在统计学上的显著差异,疾病得到控制后pH值升高(p<0.001)。治疗患者的唾液量也显著高于治疗前患者(p=0.009)。
这些发现表明唾液pH值和体积受胃食管内容物的影响,并且唾液pH值监测可能成为诊断和控制LPR的一种经济有效的方法。