A team from Winston-Salem, North Carolina, USA, investigated the prevalence of esophagitis in patients with pH-documented laryngopharyngeal reflux.
A total of 58 consecutive patients with documented laryngopharyngeal reflux were enrolled in the prospective study
All of the individuals had undergone transnasal esophagoscopy as part of their reflux evaluations.
The patients had a diagnosis of laryngopharyngeal reflux confirmed by abnormal pharyngeal pH monitoring over a 5-month period.
They then completed a self-administered reflux symptom index and underwent transnasal esophagoscopy with directed biopsy.
Of the patients, the mean age was 49 years, and 53% were women.
|12% of patients with laryngopharyngeal reflux had esophagitis.
| Laryngoscope |
The authors found that 40% of the participants had heartburn and 48% had abnormal esophageal reflux (by pH monitoring criteria).
By transnasal esophagoscopy with biopsy, 12% had esophagitis and another 7% had Barrett's metaplasia.
Thus, 60% of the study cohort had no heartburn, and 81% had normal esophageal epithelium.
Dr James A. Koufman, of the Wake Forest University in Winston-Salem, said on behalf of his colleagues, "In the present series of patients with documented laryngopharyngeal reflux, the prevalence of esophagitis and Barrett's metaplasia was only 19%."
"These data confirm the clinical impression that the patterns, mechanisms, and manifestations of laryngopharyngeal reflux differ from those of classic gastroesophageal reflux disease.
"Unlike gastroesophageal reflux disease, patients with laryngopharyngeal reflux uncommonly have esophagitis," he added.
"Thus, although esophagoscopy may be an excellent method for screening the esophagus, it is not the method of choice for diagnosing laryngopharyngeal reflux," he concluded.