Diagnosis of Gastroesophageal Reflux Disease (GERD) in Otorhinolaryngology

Investigation in Combinations of Complicating Symptoms and Laryngeal Findings

Abstract

Gastroesophageal Reflux Disease (GERD) patients who complain about otorhinolaryngologic symptoms, are labeled as having Laryngopharyngeal Reflux Disease (LPRD) in the United States and Europe. With GERD, the most definitive manifestation tools are upper gastrointestinal endoscopy and 24-hour ambulatory dual-probe pH monitaring. These diagnostic methods are uncomfortable to patients.
In this time, investigation whether otorhinolaryngologist can diagnose LPRD or not is reported. Endoscopic reflux esophagitis in combinations of complicating symptoms and laryngeal findings are investigated in 41 patients, 26 male and 15 female, who complained globus sensation. Endoscopic reflux esophagitis is found in 15 out of 31 patients (48.3%).
In laryngeal findings, arytenoid reddening, arytenoid swelling (AR and AS group), and interarytenoid pachydermia (IP group) are found in 34 patients (82.6%). In complicating symptoms, appearance or worsening of globus sensation after meals is found in 33 patients (80.5%).
With investigation of combinations, endoscopic reflux esophagitis is found in 10 out of 14 AR and AS group patients (71.4%) and 10 out of 15 IP group patients (66.6%). Their data have no significance as compared with combinations of other symptoms.
However, combinations of patients' complicating symptoms and laryngeal findings are very useful for diagnosis of LPRD. In particular, the appearance or worsening of globus sensation after meals is very useful in inquiry and arytenoid reddening, arytenoid swelling and interarytenoid pachydermia are very useful in laryngeal findings.