Salihefendic Nizama, Zildzic Muharem, Cabric Emir
Department of Emergency Medicine, Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.
Medicus A Gracanica, Gracanica, Bosnia and Herzegovina.
Med Arch. 2017 Jun;71(3):215-218. doi: 10.5455/medarh.2017.71.215-218.
Laryngopharyngeal reflux disease (LPRD) referes to an inflammatory reaction of the mucous membrane of pharynx, larynx and other associated respiratory organs, caused by a reflux of stomach contents into the esophagus. LPRD is considered to be a relatively new clinical entity with a vast number of clinical manifestations which are treated through different fields of medicine, often without a proper diagnosis. In gastroenterology it is still considered to be a manifestation of GERD, which stands for gastroesophageal reflux disease. Patients suffering from LPRD communicate firstly with their primary physicians, and since further treatment might ask for a multidisciplinary approach, it is important to have a unified approach among experts when treating these patients.
This paper is written with the intention to assess the frequency of symptoms of LPR in family medicine, possible diagnostics and adequate treatment in primary health care.
This is a prospective, descriptive cohort study. Authors used "The Reflux Symptom Index" (RSI) questionnaire. Examinees were all patients who reported to their family medicine office in Gracanica for the first time with new symptoms during a period of one year. Patients with positive results for LPR (over 13 points) were treated in accordance with the suggested algorithm and were monitored during the next year.
Out of 2123 examinees who showed symptoms of LPR, 390 tested positive according to the questionnaire. This group of examinees were treated in accordance with all suggested protocols and algorithms. 82% showed signs of improvement as a response to basic treatment provided by their physicians.
Almost every fifth patient who reports to their family medicine physician shows symptoms of LPR. On primary health care levels it is possible to establish some form of prevention, diagnostics and therapy for LPR in accordance with suggested algorithms. Only a small number of patients requires procedures which fall under other clinical fields.
喉咽反流病(LPRD)是指胃内容物反流至食管引起的咽、喉及其他相关呼吸器官黏膜的炎症反应。LPRD被认为是一种相对较新的临床病症,有大量临床表现,常通过不同医学领域进行治疗,且往往缺乏正确诊断。在胃肠病学中,它仍被视为胃食管反流病(GERD)的一种表现形式。LPRD患者首先会与他们的初级医生沟通,由于进一步治疗可能需要多学科方法,因此在治疗这些患者时,专家之间采用统一方法很重要。
本文旨在评估家庭医学中LPR症状的发生率、初级卫生保健中的可能诊断方法及适当治疗。
这是一项前瞻性描述性队列研究。作者使用了“反流症状指数”(RSI)问卷。受检者为在一年期间首次因新症状前往格拉查尼察家庭医学诊所就诊的所有患者。LPR检测呈阳性(超过13分)的患者按照建议的算法进行治疗,并在次年接受监测。
在2123名有LPR症状的受检者中,390人根据问卷检测呈阳性。这组受检者按照所有建议的方案和算法进行治疗。82%的患者对医生提供的基础治疗有改善迹象。
几乎每五名向家庭医生求诊的患者中就有一名表现出LPR症状。在初级卫生保健层面,根据建议的算法可以建立某种形式的LPR预防、诊断和治疗方法。只有少数患者需要其他临床领域的治疗程序。