Mosli Mahmoud, Alkhathlan Bashaer, Abumohssin Abdulmalik, Merdad Mazin, Alherabi Ameen, Marglani Osama, Jawa Hani, Alkhatib Talal, Marzouki Hani Z
Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Saudi J Gastroenterol. 2018 Jul-Aug;24(4):236-241. doi: 10.4103/sjg.SJG_518_17.
BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) is a common condition that can lead to significant morbidity. Laryngopharyngeal reflux (LPR) is a distinct clinical entity that can occur simultaneously with GERD, necessitating additional treatment measures. The degree of overlap and clinical predictors of LPR among patients with GERD remains unknown. We aim to measure the prevalence of LPR in patients with GERD and identify clinical predictors.
We performed a cross-sectional study involving patients with confirmed GERD according to the GERD questionnaire (GerdQ) using the reflux symptom index (RSI). Data on demographics, comorbidities, past and current medications, and GERD-related lifestyle measures were documented. The prevalence of LPR was calculated. Linear and logistic regression analyses were conducted to correlate GerdQ and RSI, and to identify clinical predictors of LPR, respectively.
A total of 80 patients with confirmed GERD were consecutively recruited and surveyed. Mean age was 43 (±16) and 60% were females. The majority of patients were Saudis (51%) and only 24% were smokers. The mean duration of GERD was 7 (±4.4) years and the average body mass index (BMI) was 36 ± 22. Sixty-six percent of the patients consumed coffee on regular basis. On simple and multiple linear regression analyses, a strong, positive correlation was observed between the GerdQ and RSI scores (coefficient = 1.13, 95%CI = 0.39-1.86), and ipratropium bromide inhaler was positively associated with RSI scores (coefficient = 13.12, 95%CI = 0.16-26.09). LPR was identified in 57 patients (71%). On simple and multiple logistic regression analyses, GerdQ scores (OR = 1.78, 95%CI = 1.13-2.80), BMI (OR = 1.07, 95%CI = 1.01-1.14), duration of GERD in years (OR = 1.42, 95%CI = 1.04-1.93), and the type of gender (OR = 49.67, 95%CI = 1.32-1870) appeared to increase the risk of LPR, whereas coffee consumption (OR = 0.0005, 95%CI = 1.82e-06, 0.13) appeared to be negatively associated with LPR.
Contradictory to what is frequently reported, LPR commonly occurs and positively correlates with GERD. Several modifiable clinical predictors of LPR might exist, which highlight the importance of performing a complete clinical assessment of the patients with reflux symptoms.
背景/目的：胃食管反流病（GERD）是一种常见疾病，可导致严重的发病率。喉咽反流（LPR）是一种独特的临床实体，可与GERD同时发生，需要额外的治疗措施。GERD患者中LPR的重叠程度和临床预测因素尚不清楚。我们旨在测量GERD患者中LPR的患病率并确定临床预测因素。
我们进行了一项横断面研究，纳入根据GERD问卷（GerdQ）确诊为GERD的患者，并使用反流症状指数（RSI）。记录了人口统计学、合并症、过去和当前用药情况以及与GERD相关的生活方式措施的数据。计算LPR的患病率。分别进行线性和逻辑回归分析，以关联GerdQ和RSI，并确定LPR的临床预测因素。
共连续招募并调查了80例确诊为GERD的患者。平均年龄为43岁（±16岁），60%为女性。大多数患者是沙特人（51%），只有24%是吸烟者。GERD的平均病程为7年（±4.4年），平均体重指数（BMI）为36±22。66%的患者经常喝咖啡。在简单和多元线性回归分析中，观察到GerdQ和RSI评分之间存在强正相关（系数=1.13，95%CI=0.39-1.86），异丙托溴铵吸入器与RSI评分呈正相关（系数=13.12，95%CI=0.16-26.09）。57例患者（71%）被诊断为LPR。在简单和多元逻辑回归分析中，GerdQ评分（OR=1.78，95%CI=1.13-2.80）、BMI（OR=1.07，95%CI=1.01-1.14）、GERD病程（年）（OR=1.42，95%CI=1.04-1.93）和性别类型（OR=49.67，95%CI=1.32-1870）似乎增加了LPR的风险，而咖啡消费（OR=0.0005，95%CI=1.82e-06，0.13）似乎与LPR呈负相关。
与经常报道的情况相反，LPR常见且与GERD呈正相关。可能存在几种可改变的LPR临床预测因素，这突出了对有反流症状患者进行全面临床评估的重要性。
