[Proximal gastro-esophageal reflux monitoring in patients with suspected laryngopharyngeal reflux disease].

AIMS

To assess the frequency and associated factors of proximal acid reflux in patients with ENT manifestations of gastroesophageal reflux disease, and to compare the pHmetric parameters in the distal and the proximal esophagus in these patients.

METHODS

We conducted an open-prospective study, including consecutive patients with chronic pharyngitis or laryngitis. Twenty-four hour esophageal pH-monitoring was performed, using a double sensor catheter. Proximal reflux was defined according to the recently published recommendations.

RESULTS

We studied 43 patients (17 men and 26 women), mean age: 39.5 years (15 - 67 years). Distal reflux was detected in 35 patients (81%). Proximal reflux was detected in 26 patients (60%). Ratio of numbers of proximal to distal reflux episodes was 0.34 (0 - 0.90). The proximal reflux episodes were characterized by a small number of episodes exceeding 5 minutes (2.6 + 4.4 vs 10.8 + 9.1; p < 0.0001), a less duration of longest reflux episode (15.6 + 23.5 vs 50.2 + 61.6 minutes; p < 0.0001) and better esophageal clearance (1.6 + 1 vs 2.5 + 1 minutes/reflux: p = 0.006), associated with a significant correlation between numbers of proximal reflux episodes and distal acid exposure time (r = 0.52: p < 0.0001).

CONCLUSION

Proximal reflux is frequent in patients with chronic pharyngitis or laryngitis. Proximal reflux episodes are correlated to distal acid exposure and associated with a better esophageal clearance.