Laryngopharyngeal reflux and chronic sinusitis

Laryngopharyngeal reflux disease: Updated examination of mechanisms, pathophysiology, treatment, and association with gastroesophageal reflux disease

Laryngopharyngeal reflux disease (LPRD) is an inflammatory condition in the laryngopharynx and upper aerodigestive tract mucosa caused by reflux of stomach contents beyond the esophagus. LPRD commonly presents with sym-ptoms such as hoarseness, cough, sore throat, a feeling of throat obstruction, excessive throat mucus. This complex condition is thought to involve both reflux and reflex mechanisms, but a clear understanding of its molecular mechanisms is still lacking. Currently, there is no standardized diagnosis or treatment protocol. Therapeutic strategies for LPRD mainly include lifestyle modifications, proton pump inhibitors and endoscopic surgery. This paper seeks to provide a comprehensive overview of the existing literature regarding the mechanisms, patho-physiology and treatment of LPRD. We also provide an in-depth exploration of the association between LPRD and gastroesophageal reflux disease.

A Study on the Prevalence of Laryngopharyngeal Reflux in Saudi Arabia

Introduction Laryngopharyngeal reflux (LPR) is a condition characterized by the backflow of gastric contents rising through the esophagus, affecting the aerodigestive tract and leading to throat symptoms such as hoarseness, chronic cough, and throat clearing. LPR is recognized as a separate condition from gastroesophageal reflux disease, despite the fact that they both involve the backflow of the stomach contents as their primary pathology. Our study aimed to evaluate the prevalence of LPR within the population of Saudi Arabia. Methods A cross-sectional study was conducted using an electronic questionnaire from August to November 2023, involving participants from all five regions of Saudi Arabia. A total of 1140 participants completed the questionnaire, which included the Reflux Symptom Index (RSI) to assess the prevalence of LPR. Results LPR was found to be prevalent in 31.2% of the study population, with the most common associated demographics being female gender (p = 0.032) and adults aged 36-45 years (p = 0.006). However, no significant relationship was observed based on region of residence or other demographic factors such as education level or occupation. Conclusion LPR has a high prevalence in the population of Saudi Arabia. Therefore, further research and awareness about this condition are warranted to better understand its impact, improve diagnosis, and develop appropriate management strategies.

Laryngopharyngeal Reflux and Inflammatory Responses in Mucosal Barrier Dysfunction of the Upper Aerodigestive Tract

The upper aerodigestive tract (UAT) is the first line of defense against environmental stresses such as antigens, microbes, inhalants, foods, etc., and mucins, intracellular junctions, epithelial cells, and immune cells are the major constituents of this defensive mucosal barrier. Laryngopharyngeal reflux (LPR) is recognized as an independent risk factor for UAT mucosal disorders, and in this review, we describe the components and functions of the mucosal barrier and the results of LPR-induced mucosal inflammation in the UAT. We discuss the interactions between the refluxate and the mucosal components and the mechanisms through which these damaging events disrupt and alter the mucosal barriers. In addition, we discuss the dynamic alterations in the mucosal barrier that might be potential therapeutic targets for LPR-induced disorders.