Original scientific paper

https://doi.org/10.57140/mj.52.2.1

Analysis of symptoms and clinical signs of laryngopharyngeal reflux depending on pepsia in saliva

Josip Maleš ; J.J. Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia, University hospital centre Osijek, Department of otorhinolaryngology, head and neck surgery, Osijek, Croatia
Tin Prpić ; J.J. Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia, University hospital centre Osijek, Department of otorhinolaryngology, head and neck surgery, Osijek, Croatia
Andrijana Včeva ; J.J. Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia, University hospital centre Osijek, Department of otorhinolaryngology, head and neck surgery, Osijek, Croatia
Tihana Mendeš ; J.J. Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia, University hospital centre Osijek, Department of otorhinolaryngology, head and neck surgery, Osijek, Croatia
Ivan Abičić ; J.J. Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia, University hospital centre Osijek, Department of otorhinolaryngology, head and neck surgery, Osijek, Croatia
Matej Rezo ; J.J. Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia, University hospital centre Osijek, Department of otorhinolaryngology, head and neck surgery, Osijek, Croatia

Abstract

In the last fifty years, an epidemic of reflux disease has occurred as a result of poor eating habits, stress,
and activities of the food industry. Part of this disease is laryngopharyngeal reflux, a disease characterized by
the return of gastric contents to the throat and surrounding organs, leading to hoarseness, coughing, difficulty
in swallowing and breathing, and ultimately the development of benign and malignant changes in the larynx.
This study is aimed to examine the symptoms and signs of laryngopharyngeal reflux in the study group
before and after therapy and to compare the concentration of pepsin in saliva with the above. The prospective
longitudinal cohort study included 50 subjects, divided into two groups. The first group consisted of 25
subjects with laryngopharyngeal reflux. The second group consisted of 25 healthy subjects without symptoms
and signs of laryngopharyngeal reflux. Symptoms and signs before and after therapy were collected using RSI
and RFS questionnaires. Pepsin in saliva was measured with Peptest before and after therapy. The most
pronounced symptoms are hoarseness, postnasal drip, and a feeling of "a lump in the throat". The median RSI
score after three months of therapy was reduced from 20 to 8. From the first group, 7 subjects had measurable
levels of pepsin in saliva, and none after therapy. In the control group, no subjects were found to have pepsin
in their saliva. Significant improvement was observed in clinical findings (subglottic edema, posterior
commissure hypertrophy, vocal cord edema, dense endolaryngeal secretion) after three months of therapy in
subjects with LPR. No association of pepsin with LPR symptoms was observed but there is a significant
positive association between pepsin and the clinical finding of erythema/hyperemia.
In most cases, we start therapy with medication. It is, therefore, important to emphasize that
laryngopharyngeal reflux treatment must always begin with a change in diet, lifestyle, and stress regulation.
Treatment must be individual and should include a multidisciplinary team with a nutritionist, psychologist,
and psychiatrist.

Keywords

food habits; laryngopharyngeal reflux; peptest; pepsin; treatment; diagnosis

Hrčak ID:

281501

URI

https://hrcak.srce.hr/281501

Publication date:

25.8.2022.

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