1
|
Krause AJ, Taft T, Greytak M, Burger ZC, Walsh E, Weissbrod P, Pandolfino JE, Yadlapati R. Validation of the Laryngeal Cognitive-Affective Tool. Clin Gastroenterol Hepatol 2024; 22:1395-1403.e3. [PMID: 38309495 PMCID: PMC11193647 DOI: 10.1016/j.cgh.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND & AIMS Cognitive-affective processes, including hypervigilance and symptom-specific anxiety, may contribute to chronic laryngeal symptoms and are potentially modifiable; however, a validated instrument to assess these constructs is lacking. The aims of this study were to develop and validate the Laryngeal Cognitive-Affective Tool (LCAT) instrument. METHODS This 2-phase single-center prospective study enrolled participants from November 2021 to June 2023. In the initial phase 1:1 patient cognitive interviews and multidisciplinary team consensus were conducted to develop the LCAT. In the second phase asymptomatic and symptomatic participants completed a series of questionnaires to examine psychometric properties of the LCAT. RESULTS A total of 268 participants were included: 8 in the initial phase and 260 in the validation phase (56 asymptomatic; 204 symptomatic). A 15-item LCAT was developed. In the validation phase, mean total LCAT and hypervigilance/anxiety subscores were significantly higher in symptomatic versus asymptomatic participants (P < .01). The LCAT had excellent internal consistency (α = 0.942) and split-half reliability (Guttman = 0.853). Using a median split, a score of 33 or greater was defined as elevated. CONCLUSIONS The 15-item LCAT evaluates laryngeal hypervigilance and symptom-specific anxiety among patients with laryngeal symptoms. It has excellent reliability and construct validity. The LCAT highlights burdensome cognitive-affective processes that can accordingly help tailor treatments.
Collapse
Affiliation(s)
- Amanda J Krause
- Division of Gastroenterology & Hepatology, Department of Medicine, University of California San Diego, La Jolla, California
| | - Tiffany Taft
- Division of Gastroenterology & Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Madeline Greytak
- Division of Gastroenterology & Hepatology, Department of Medicine, University of California San Diego, La Jolla, California
| | - Zoe C Burger
- Division of Gastroenterology & Hepatology, Department of Medicine, University of California San Diego, La Jolla, California
| | - Erin Walsh
- Department of Otolaryngology, University of California San Diego, La Jolla, California
| | - Philip Weissbrod
- Department of Otolaryngology, University of California San Diego, La Jolla, California
| | - John E Pandolfino
- Division of Gastroenterology & Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Rena Yadlapati
- Division of Gastroenterology & Hepatology, Department of Medicine, University of California San Diego, La Jolla, California.
| |
Collapse
|
2
|
Liu K, Krause AJ, Greytak M, Taft T, Walsh E, Yadlapati R. Psychosocial burden in patients with chronic laryngopharyngeal symptoms with and without pathologic acid reflux. Neurogastroenterol Motil 2024:e14852. [PMID: 38923769 DOI: 10.1111/nmo.14852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Patients with chronic laryngopharyngeal symptoms, with or without pathologic reflux, frequently have poor response to standard therapies, which may be a result of overlapping cognitive-affective processes. Therefore, the aims of this study included measuring psychosocial distress and laryngeal-specific cognitive distress in patients with chronic laryngopharyngeal symptoms (LPS) as well as comparing these among laryngeal symptomatic patients with and without conclusive gastroesophageal reflux disease (GERD). METHODS This prospective, single-center study enrolled adults with chronic LPS from 9/22 to 6/23. Patients completed eight questionnaires on quality of life, symptom burden, and psychosocial distress. The laryngeal cognitive affective tool (LCAT) assessed laryngeal-specific hypervigilance and anxiety; LCAT scores ≥33 were elevated. All patients underwent objective testing with endoscopy and/or ambulatory reflux monitoring and were categorized as proven GERD (GER+) or no proven GERD (GER-). KEY RESULTS One hundred twenty-nine patients were included: 66% female, mean age 54.1 (17.5) years, mean BMI 27.6 (6.8) kg/m2, 66% Caucasian, 57% with an elevated LCAT, and 53% GER+. Moderate-to-severe anxiety was found in 39% and moderate-to-severe depression in 19%. An elevated LCAT alone or with an elevated anxiety/depression score was found in 58%. Patient-reported outcomes scores, including LCAT scores (32.9 (13.8) GER- vs. 33.1 (12.6) GER+, p = 0.91), were similar between patients with and without GER+. CONCLUSIONS AND INFERENCES Patients with chronic LPS experience heightened levels of hypervigilance, symptom-specific anxiety, and psychosocial distress, regardless of the presence of pathologic GER.
Collapse
Affiliation(s)
- Kelli Liu
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Amanda J Krause
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Madeline Greytak
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Tiffany Taft
- Rome Foundation Research Institute, Raleigh, North Carolina, USA
- Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Erin Walsh
- Department of Otolaryngology, University of California San Diego, La Jolla, California, USA
| | - Rena Yadlapati
- Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
3
|
Balouch B, Vaid A, Vontela S, Alnouri G, Sataloff RT. Anatomic and Manometric Abnormalities of the Upper and Lower Esophageal Sphincters in Patients With Reflux Disease. J Voice 2024; 38:746-753. [PMID: 35022151 DOI: 10.1016/j.jvoice.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
RESEARCH QUESTION Laryngopharyngeal reflux (LPR) may cause inflammation of the laryngeal and pharyngeal mucosa. Gastroesophageal reflux disease (GERD) involves retrograde flow of gastric content into the esophagus below the upper esophageal sphincter (UES). The goal of this study was to investigate the esophageal anatomical and manometric variations of the esophagus in patients with LPR and/or GERD. METHODS Adult voice center patients who underwent diagnostic workup for reflux complaints with 24-hour multichannel intraluminal pH-impedance testing and esophageal manometry were included in this retrospective study. Subjects were classified as having LPR (>10 proximal reflux events), LPR + GERD (>10 proximal reflux events plus >73 distal reflux events) or were assigned to a control group (≤10 proximal events and ≤73 distal reflux events) based on pH study results. Anatomic and manometric parameters were evaluated between groups. RESULTS There were 169 cases (65 male, 104 female) included in this study. The average age was 50.50 ± 17.29. Subjects in the LPR group had significantly higher UES relaxation pressures and greater UES length compared with the control group. Lower esophageal sphincter relaxation pressure was significantly higher in the control group compared with the LPR group or the GERD + LPR group. Subjects in the GERD + LPR group had a significantly shorter intra-abdominal portion of the lower esophageal sphincter compared with the LPR only group and the control group. Intrabolus pressure was significantly lower in both the LPR group and the LPR + GERD group compared with the control group. Distal wave amplitude was significantly lower in the LPR + GERD group compared to both the LPR group and the control group. The percentage of swallows with incomplete clearance was significantly greater in the LPR + GERD group than both the control group and the LPR group. The LPR group had significantly fewer swallows with incomplete clearance than the control group. CONCLUSIONS Anatomic and manometric abnormalities are present in subjects with LPR with or without GERD and may contribute to the pathogenesis of reflux disease. Further research is needed to confirm or refute these findings.
Collapse
Affiliation(s)
- Bailey Balouch
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Anuj Vaid
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Swetha Vontela
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Ghiath Alnouri
- Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Robert T Sataloff
- Department of Otolaryngology - Head and Neck Surgery, Senior Associate Dean for Clinical Academic Specialties, Drexel University College of Medicine, Director of Otolaryngology and Communication Sciences Research, Lankenau Institute for Medical Research, Philadelphia, Pennsylvania.
| |
Collapse
|
4
|
Li Q, Duan H, Wang Q, Dong P, Zhou X, Sun K, Tang F, Wang X, Lin L, Long Y, Sun X, Tao L. Analyzing the correlation between gastroesophageal reflux disease and anxiety and depression based on ordered logistic regression. Sci Rep 2024; 14:6594. [PMID: 38503861 PMCID: PMC10951219 DOI: 10.1038/s41598-024-57101-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/14/2024] [Indexed: 03/21/2024] Open
Abstract
Numerous studies have indicated a connection between psychiatric symptoms, specifically anxiety and depression, and gastroesophageal reflux. However, the precise nature of the link between the severity of gastroesophageal reflux disease and the severity of anxiety and depression remains uncertain. Here, we gathered 24-h pH monitoring data and baseline patient information from a cohort of 518 individuals. Additionally, we evaluated their psychological well-being using the Hospital Anxiety and Depression Scale. The relationship between baseline characteristics and varying degrees of anxiety, depression, and gastroesophageal reflux disease (GERD) was assessed using R software version 4.1.3 and logistic regression models. The findings indicate a statistically significant variation in anxiety levels based on gender, as well as a significant disparity in depression groups when considering age and literacy levels. Kruskal-Wallis test analysis revealed a significant positive correlation between the severity of anxiety and depression and the 24-h pH monitoring results in our patient cohort. As the anxiety and depression levels increased, the rank mean for each examination result also increased. Logistic regression modeling analysis showed that a higher anxiety level was associated with a higher level of GERD. In the presence of mild anxiety, there is a statistically significant association with a higher incidence of GERD with an odds ratio (OR) of 2.64 (95% CI 1.50, 4.64). Similarly, the moderately severe anxiety group also exhibits a causal relationship with an increased GERD incidence, with an OR of 6.84 (95% CI 3.92, 12.17). Additionally, moderate to severe depression is associated with a higher incidence of GERD, with an OR of 2.32 (95% CI 1.23, 4.37). The prevalence of GERD was greater among males compared to females (OR 2.29, 95% CI 1.51-3.49). Additionally, an elevated body mass index (BMI) demonstrated a positive correlation with the susceptibility to GERD (OR 1.07, 95% CI 1.01-1.14). Increasing age may promote the occurrence of GERD in patients. These findings may help to provide a better basis for psychological or pharmacological interventions for GERD patients with psychosomatic symptoms in the future, and provide a reference basis for clinical treatment of the disease.
Collapse
Affiliation(s)
- Qian Li
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Hui Duan
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Qiong Wang
- The Third People's Hospital of Chengdu, Chengdu, China.
| | - Peiwen Dong
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Xinxu Zhou
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Kaidi Sun
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Feng Tang
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Xinxin Wang
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Lin Lin
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Yanchan Long
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Xiaobin Sun
- The Third People's Hospital of Chengdu, Chengdu, China
| | - Lan Tao
- The Third People's Hospital of Chengdu, Chengdu, China
| |
Collapse
|
5
|
Ardizzone A, Mannino D, Casili G, Campolo M, Paterniti I, Lanza M, Filippone A, Repici A, Bova V, Capra AP, Cuzzocrea S, Esposito E. Efficacy of an oral suspension containing xyloglucan and pea proteins on a murine model of gastroesophageal reflux disease. Phytother Res 2024; 38:1610-1622. [PMID: 38296262 DOI: 10.1002/ptr.8133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/23/2023] [Accepted: 01/11/2024] [Indexed: 03/14/2024]
Abstract
Gastroesophageal reflux disease (GERD) is the most common foregut disease, affecting about 20% of the adult population. Esophageal epithelial barrier plays a fundamental role in the pathophysiology of GERD; however, pharmacological therapies mainly aim to reduce the acidity of the gastroesophageal environment rather than to protect esophageal tissue integrity. This study aims to evaluate the efficacy of an oral solution containing xyloglucan and pea proteins (XP) in reestablishing gastroesophageal tissue integrity and biochemical markers. To induce GERD, C57BL/6 mice were alternatively overfed and fasted for 56 days and then treated with XP, sodium alginate, omeprazole, or omeprazole+XP twice daily for 7 days. Gastric pain and inflammatory markers were evaluated after 3 and 7 days of treatment. After sacrifice, the esophagi and stomachs were surgically removed for macroscopic and histological examination. Gastric pain was significantly reduced at days 3 and 7 by XP, omeprazole, and omeprazole+XP, while alginates were ineffective at day 3. XP was able to diminish gastric macroscopic damage and demonstrated the same efficacy as omeprazole in reducing esophageal damage. XP significantly reduced histological damage, with an efficacy comparable to that of omeprazole, but superior to alginates. Inflammatory markers were significantly reduced by XP, with superior efficacy compared with alginates at day 7. Interestingly, XP was also able to significantly increase gastric pH. This study demonstrated that XP restored gastric homeostasis, improved esophageal integrity, and decreased inflammation and pain with a similar efficacy to omeprazole and greater than alginates.
Collapse
Affiliation(s)
- Alessio Ardizzone
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Deborah Mannino
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Giovanna Casili
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Michela Campolo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Irene Paterniti
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Marika Lanza
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Alessia Filippone
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Alberto Repici
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Valentina Bova
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Anna Paola Capra
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Emanuela Esposito
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| |
Collapse
|
6
|
Zheng X, Chen Z, Chen T, Zhou L, Liu C, Zheng J, Hu R. Assessing the role of dryness and burning sensation in diagnosing laryngopharyngeal reflux. Sci Rep 2024; 14:4542. [PMID: 38402357 PMCID: PMC10894288 DOI: 10.1038/s41598-024-55420-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 02/23/2024] [Indexed: 02/26/2024] Open
Abstract
Laryngopharyngeal reflux disease (LPRD) is a condition characterized by the regurgitation of stomach and duodenal contents into the laryngopharynx, with variable and non-specific symptoms. Therefore, developing an accurate symptom scale for different regions is essential. Notably, the symptoms of "dryness and burning sensation in the laryngopharynx or mouth" are prevalent among the Chinese population but are often omitted from conventional symptom assessment scales, such as the Reflux Symptom Index (RSI) and Reflux Symptom Score-12 (RSS-12) scales. To address this gap, our study incorporated the symptoms into the RSI and RSS-12 scales, developing the RSI-10/RSS-13 scales. Afterward, we assessed the role of the new scale's reliability (Cronbach's α and test-retest reliability), construct validity (confirmatory factor analysis and confirmatory factor analysis), and diagnostic efficiency. Our study encompassed 479 participants (average = 39.5 ± 13.4 years, 242 female) and 91 (average = 34.01 ± 13.50 years, 44 female) completed 24 h MII-pH monitoring. The Cronbach's α values of 0.80 and 0.82 for the RSI-10 and RSS-13 scales, respectively. RSI-10 and RSS-13 exhibited strong test-retest reliability (ICCs = 0.82-0.96) and diagnostic efficacy (AUC = 0.84-0.85). Furthermore, the factor analysis identified the RSS-13 and its three sub-scales (ear-nose-throat, digestive tract, respiratory tract) exhibited good to excellent structural validity (χ2/df = 1.95, P < 0.01; CFI = 0.95, RMSEA = 0.06, SRMR = 0.05). The AUC optimal thresholds for the RSI-10 and RSS-13 in the Chinese population were 13 and 36, respectively. Besides, the inclusion of the new item significantly improved the diagnostic efficiency of the RSI scale (P = 0.04), suggesting that RSI-10 holds promise as a more effective screening tool for LPRD, and global validation is needed to demonstrate the impact of this new symptom on the diagnosis of LPRD.
Collapse
Affiliation(s)
- Xiaowei Zheng
- Department of Otorhinolaryngology Head and Neck Surgery, Shengli Clinical Medical College of Fujian Medical University, 134 Dong Jie, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Zhiwei Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Shengli Clinical Medical College of Fujian Medical University, 134 Dong Jie, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Ting Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Shengli Clinical Medical College of Fujian Medical University, 134 Dong Jie, Gulou District, Fuzhou City, 350001, Fujian Province, China.
| | - Liqun Zhou
- Department of Otorhinolaryngology Head and Neck Surgery, Shengli Clinical Medical College of Fujian Medical University, 134 Dong Jie, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Chaofeng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Shengli Clinical Medical College of Fujian Medical University, 134 Dong Jie, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Jingyi Zheng
- Department of Otorhinolaryngology Head and Neck Surgery, Shengli Clinical Medical College of Fujian Medical University, 134 Dong Jie, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Renyou Hu
- Chongqing Jinshan Science and Technology (Group) Co Ltd, Chongqing, 401120, China
| |
Collapse
|
7
|
Zamani M, Alizadeh-Tabari S, Chan WW, Talley NJ. Association Between Anxiety/Depression and Gastroesophageal Reflux: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2023; 118:2133-2143. [PMID: 37463429 DOI: 10.14309/ajg.0000000000002411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 07/14/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION An association between gastroesophageal reflux disease (GERD) and common psychiatric conditions, most notably anxiety and depression, has been reported. However, the magnitude of this association is poorly understood. Therefore, we aimed to systematically assess this issue. METHODS We comprehensively searched multiple bibliographic databases (Embase, PubMed, Scopus, and Web of Science) from inception to May 15, 2023. We retrieved observational studies that reported the prevalence of anxiety and/or depressive symptoms diagnosed by validated questionnaires in ≥100 adults (aged 18 years or older) with GERD. We also included cohort studies that explored the risk of incident GERD in subjects with anxiety/depression vice versa scenario. Finally, we included Mendelian randomization studies that assessed the cause-and-effect relationship between anxiety/depression and GERD. The extracted data were combined using a random-effects model. RESULTS In total, 36 eligible studies were included. The pooled prevalences of anxiety and depressive symptoms were 34.4% (95% confidence interval [CI] 24.7-44.2; I2 = 99.4%) and 24.2% (95% CI 19.9-28.5; I2 = 98.8%) in subjects with GERD based on 30 studies, respectively. Both anxiety and depressive symptoms were more common in subjects with GERD compared with those in healthy controls (odds ratio = 4.46 [95% CI 1.94-10.25] and odds ratio = 2.56 [95% CI 1.11-5.87], respectively). According to 3 cohort studies, subjects with GERD were at an increased risk of developing anxiety/depression and vice versa. Finally, 3 Mendelian randomization studies showed that genetic liability to these mood disorders is linked to an increased risk of developing GERD and vice versa. DISCUSSION Up to 1 in 3 subjects with GERD experience anxiety and depression. There is likely a bidirectional causal relationship between anxiety/depression and GERD.
Collapse
Affiliation(s)
- Mohammad Zamani
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Alizadeh-Tabari
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Walter W Chan
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nicholas J Talley
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| |
Collapse
|
8
|
Kwon SK, Park SJ, Chung EJ, Sohn JH, Sun DI, Jin SM, Lee BJ, Park IS, Cho JG, Park YH. Predictors of Early and Late Response to Esomezol and Lifestyle Modification in Adults With Laryngopharyngeal Reflux Disease: A Prospective, Multicenter, Open-Label Cohort Study. Clin Exp Otorhinolaryngol 2023; 16:259-274. [PMID: 37350172 PMCID: PMC10471909 DOI: 10.21053/ceo.2023.00409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/31/2023] [Accepted: 06/18/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES This study aimed to assess predictors of the response to varying durations of proton pump inhibitor (PPI) use and lifestyle modification treatment for laryngopharyngeal reflux disease (LPRD). METHODS Between October 2014 and June 2016, a prospective, multicenter, open-label, single-cohort, intention-to-treat, observational study was conducted at eight referral hospitals across the Republic of Korea to examine predictors of early and late response to treatment in adult patients (age ≥19 years) with LPRD. Participants underwent standard treatment (PPI [Esomezol] and lifestyle modification) for 3 months. Response to treatment was defined as greater than 50% improvement in reflux symptom index score. The primary outcome was potential predictors of treatment response at 1 and 3 months. The secondary outcome was potential predictors distinguishing early from late responders. RESULTS In total, 394 patients were enrolled. Improved sleep habits was a positive predictor (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.06-3.007; P=0.029), while initial alcohol consumption (OR, 0.587; 95% CI, 0.355-0.969; P=0.037) and past medication history (OR, 0.438; 95% CI, 0.215-0.891; P=0.005) were negative predictors of response after 1 month of treatment. High pre-reflux finding score was a positive predictor (OR, 1.187; 95% CI, 1.049- 1.344; P=0.007), while male sex (OR, 0.516; 95% CI, 0.269-0.987; P=0.046), higher depression score (OR, 0.867; 95% CI, 0.784-0.958; P=0.005), and past thyroid hormone medication history (OR, 0.161; 95% CI, 0.033-0.788; P=0.024) were negative predictors of response after 3 months of treatment. Past medication history (OR, 0.438; 95% CI, 0.215-0.891; P=0.023) was the only negative predictor for early responders compared to late responders. CONCLUSION Adult patients with LPRD and a history of prior medication use may require longer treatment durations to achieve a therapeutic response. Future research should explore the incorporation of diverse treatment approaches to improve treatment outcomes for patients exhibiting negative prognostic indicators.
Collapse
Affiliation(s)
- Seong Keun Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Joon Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Korea
| | - Eun-Jae Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Ho Sohn
- Department of Otolaryngology-Head and Neck Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong-Il Sun
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Min Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung-Joo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Il-Seok Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Jae-Gu Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young Hak Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
9
|
Ribolsi M, Marchetti L, Blasi V, Cicala M. Anxiety correlates with excessive air swallowing and PPI refractoriness in patients with concomitant symptoms of GERD and functional dyspepsia. Neurogastroenterol Motil 2023:e14550. [PMID: 36786093 DOI: 10.1111/nmo.14550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/18/2023] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Anxiety may exacerbate GERD and FD symptoms perception and reduce quality of life. As many as 50% of patients with GERD symptoms have incomplete relief with PPI therapy, and psychological factors may influence PPI responsiveness. AIM The potential relationship between anxiety, excessive air swallowing, and PPI responsiveness was evaluated. METHODS GERD patients with concomitant FD were prospectively evaluated. Validated structured questionnaires were used to evaluate anxiety, GERD, and FD symptoms. All patients were treated, within the previous year, with at least 8 weeks of standard dose PPI therapy. RESULTS One hundred sixty-one patients were included. Frequency of non-responders in patients with moderate/severe anxiety was significantly higher compared to patients with mild anxiety (62.7% vs. 37.3%, p < 0.01). Patients with moderate/severe anxiety displayed a significantly higher mean FD symptoms score value compared to patients with mild anxiety. A significantly higher mean number of air swallows were observed in patients with moderate/severe anxiety. At ROC analysis, air swallows and mixed reflux episodes were significantly associated with the presence of PPI refractoriness (AUC: 0.725, 95% CI: 0.645-0.805 and 0.768, 0.692-0.843). According to univariate analysis, an abnormal number of air swallows, mixed reflux episodes and presence of moderate/severe anxiety was significantly associated with PPI refractoriness. CONCLUSION Our results, if confirmed in in a larger, prospective clinical and therapeutic study, demonstrate the usefulness of an up-front evaluation with anxiety questionnaire and esophageal testing in patients with a broad spectrum of upper gastrointestinal symptoms who fail to respond to PPI treatment, supporting the option of alternative treatment modalities.
Collapse
Affiliation(s)
- Mentore Ribolsi
- Department of Digestive Diseases, Campus Bio Medico University of Rome, Rome, Italy
| | - Lorenzo Marchetti
- Department of Digestive Diseases, Campus Bio Medico University of Rome, Rome, Italy
| | - Valentina Blasi
- Department of Digestive Diseases, Campus Bio Medico University of Rome, Rome, Italy
| | - Michele Cicala
- Department of Digestive Diseases, Campus Bio Medico University of Rome, Rome, Italy
| |
Collapse
|
10
|
Esophageal hypervigilance and visceral anxiety contribute to symptom severity of laryngopharyngeal reflux. Am J Gastroenterol 2022; 118:786-793. [PMID: 36693025 DOI: 10.14309/ajg.0000000000002151] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/14/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Laryngopharyngeal reflux (LPR) is a clinical conundrum without a diagnostic gold standard. The esophageal hypervigilance and anxiety scale (EHAS) is a questionnaire designed for cognitive-affective evaluation of visceral sensitivity. We hypothesized that esophageal hypervigilance and symptom-specific anxiety have an etiopathological role in generation of LPR symptoms, especially when gastroesophageal reflux disease (GERD) cannot explain these symptoms. METHODS Consecutive patients with LPR and/or GERD symptoms lasting >3 months were prospectively enrolled and characterized using the reflux symptom index (RSI), GERD questionnaire (GERDQ), and EHAS. Eligible patients with negative endoscopy underwent 24-hour impedance-pH monitoring off acid suppression for phenotyping GERD, and assessment of reflux burden, using conventional metrics [acid exposure time (AET) and number of reflux episodes] as well as novel metrics [mean nocturnal baseline impedance (MNBI) and post-reflux swallow induced peristaltic wave (PSPW) index]. RESULTS Of 269 enrolled patients (mean age 47.1 years, 21-65 years, 60.6% female), 90 patients with concomitant GERD and LPR symptoms, 32 patients with dominant LPR symptoms, 102 patients with dominant GERD symptoms, and 45 controls. Patients with concomitant GERD and LPR symptoms had higher EHAS than those with dominant GERD symptoms and controls. ( P ≤ 0.001); patients with dominant LPR symptoms had higher EHAS than controls. ( P = 0.007). On Pearson's correlation, EHAS positively correlated with RSI. CONCLUSIONS Esophageal hypervigilance symptom-specific anxiety may be more important than reflux burden in LPR symptom perception.
Collapse
|
11
|
Yang R, Liang F, Tian R, Yao Y, Zhang M, Li X. There is a Good Consistency Between Reflux Symptom Score-12 and Reflux Symptom Index in Chinese Population. J Voice 2022:S0892-1997(22)00373-3. [PMID: 36460539 DOI: 10.1016/j.jvoice.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the consistency between the Reflux Symptom Score-12 (RSS-12) and Reflux Symptom Index (RSI) in Chinese people. METHODS Patients with symptoms of LPR from the outpatient otorhinolaryngology-head and neck surgery clinic were included. All included patients completed the RSS-12 and RSI. The patient with RSS-12>11 or RSI>13 suggested possible LPR. For the patients with RSI >13 or RSS-12>11, they were treated using diet recommendations and were prescribed a twice-daily pantoprazole for 12 weeks. The consistency between the RSS-12 and RSI was compared with the weighted Cohen's kappa statistic. RESULTS A total of 258 patients were included. The mean scores for RSS-12 and RSI were 13.21±17.31 and 12.86±6.15, respectively. The positive rate of LPR was 17.44% based on the RSI, and 24.42% based on the RSS-12. The kappa value between the RSS-12 and RSI was 0.736 (P < 0.001). Following 12 weeks of treatment, there was a significant reduction in both RSI and RSS-12. Based on the RSI, 73% of patients had a good treatment response, whereas according to the RSS-12, 85% of patients had a good treatment response. CONCLUSION There is a good consistency between RSS-12 and RSI, meaning that the RSS-12 is a feasible LPR initial screening tool. The RSS-12 provides a more comprehensive evaluation of reflux symptoms and treatment effect than RSI in patients with LPR.
Collapse
Affiliation(s)
- Ruimin Yang
- Department of Otolaryngology, Hebei Langfang people's Hospital, Hebei, China.
| | - Fangfang Liang
- Department of Otolaryngology, Hebei Langfang people's Hospital, Hebei, China
| | - Ru Tian
- Department of Otolaryngology, Langfang Hospital of traditional Chinese medicine, Hebei, China
| | - Yang Yao
- Department of Otolaryngology, Hebei Langfang people's Hospital, Hebei, China
| | - Ming Zhang
- Department of Otolaryngology, Hebei Langfang people's Hospital, Hebei, China
| | - Xiaowen Li
- Department of Otolaryngology, Hebei Langfang people's Hospital, Hebei, China
| |
Collapse
|
12
|
Li Y, Duan Z. Updates in interaction of gastroesophageal reflux disease and extragastroesophageal digestive diseases. Expert Rev Gastroenterol Hepatol 2022; 16:1053-1063. [PMID: 35860994 DOI: 10.1080/17474124.2022.2056018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Gastroesophageal reflux disease (GERD) is one of the common chronic diseases with prevalence increasing in the last decades. Because of its prevalence and chronicity, GERD affects the quality of life and increases health-care costs. Gastroesophageal diseases leading to GERD have been thoroughly studied, while extragastroesophageal digestive diseases (EGEDDs) may coexist with GERD and affect the occurrence and persistence of GERD symptoms and therapeutic effect. AREAS COVERED In this review, we aim to summarize the EGEDDs correlated with GERD and explore the potential mechanisms of this interaction. EXPERT OPINION Individuals with troublesome GERD symptoms may have some common gastroesophageal etiologies, but EGEDDs may also overlap and impact on the progression of GERD, which are often ignored in clinic. The lesions in the small intestine, colon, and hepatobiliary tract as well as functional bowel disorders had positive or negative associations with GERD through potential mechanisms. These diseases aggravate GERD symptoms, increase the esophageal acid burden, cause esophageal hypersensitivity, and finally affect the response to therapy in GERD patients. Therefore, it is necessary to clear the interaction between GERD and EGEDDs and their mechanisms.
Collapse
Affiliation(s)
- Yanqiu Li
- Second Gastroenterology Department, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Zhijun Duan
- Second Gastroenterology Department, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| |
Collapse
|
13
|
Wang X, Zhang J, Liu Z, Zhang C, Zou S, Li J. Investigation of Reflux Characteristics in Outpatients of Otorhinolaryngology-Head and Neck Surgery by Age and Gender in the Chinese Population. J Voice 2022:S0892-1997(22)00226-0. [PMID: 35985897 DOI: 10.1016/j.jvoice.2022.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To investigate the characteristics of patients with reflux diseases in the otorhinolaryngology-head and neck surgery clinics through the Reflux Symptom Scale-12 (RSS-12) and the Gastroesophageal Reflux Disease Questionnaire (GERD-Q). METHODS All included patients completed the RSS-12 and GERD-Q scales and were considered to have LPR with an RSS-12 score >11 and GERD with a GERD-Q score >7. Data were analyzed according to genders (male and female) and age (18-40, 41-60, and >60 years). RESULTS A total of 977 patients were included. the mean RSS-12 and GERD-Q score were 11.32±21.34 and 6.31±1.21, and the positive rate of LPR and GERD were 28.76% and 8.90%, respectively. Males had a higher positive rate of LPR and GERD than females, and there were more males with LPR who also had GERD. Among those with both LPR and GERD, males had significantly higher ear-nose-throat (ENT) symptom scores such as hoarseness and excess throat mucus than females. However, females had significantly higher scores of gastrointestinal (GI) symptoms, mainly indigestion and abdominal pain, and elder patients (>60 years) had higher scores of ENT, GI, respiratory symptoms, as well as the impact of symptoms on quality of life than the young patients (18-40, and 41-60 years). CONCLUSION Patients in the otorhinolaryngology-head and neck surgery clinics have different reflux characteristics by gender and age in the Chinese population. Males had more severe ENT-related symptoms of distress, while females had more complaints of GI symptoms. Older patients had higher scores for ENT, GI and respiratory symptoms.
Collapse
Affiliation(s)
- Xiaoyu Wang
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, 230032, Anhui Province, China
| | - Jinhong Zhang
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, 100048
| | - Zhi Liu
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, 100048
| | - Chun Zhang
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, 100048
| | - Shizhen Zou
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, 100048
| | - Jinrang Li
- Department of Otolaryngology, Sixth Medical Center of PLA General Hospital, Anhui Medical University, Beijing 100048, China.
| |
Collapse
|
14
|
Xiao S, Li J, Zheng H, Li X, Yang H, Zhang J, Peng X, Zhou S, Zhao C, Chen D, Xiao X, Shi L, Huangfu H, Tao Z, Chen X, Liu Y, Qu S, Wang G, Chen T, Cui X, Tian L, Zhou W, Fang H, Huang Y, Yu G, Lin Z, Tang L, He J, Ma R, Yu Z. Awareness about laryngopharyngeal reflux disease among Chinese otolaryngologists: a nationwide survey. BMJ Open 2022; 12:e058852. [PMID: 35732392 PMCID: PMC9226935 DOI: 10.1136/bmjopen-2021-058852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the status of the current knowledge about laryngopharyngeal reflux disease (LPRD) among Chinese otolaryngologists. DESIGN Multi-centre cross-sectional survey. SETTING 220 medical centres in different regions of China. PARTICIPANTS A total of 2254 otolaryngologists from 220 medical centres in China who were successfully on-site surveyed between November 2019 and December 2020. MAIN OUTCOME MEASURES Awareness about LPRD included knowledge about risk factors, symptoms, laryngoscope signs, related diseases, current diagnostic methods and treatments. RESULTS The percentage of participants who had heard of LPRD was 96.4%, with academic conferences as the most common source of information (73.3%). The most commonly known risk factor, symptom, laryngoscope sign, related disease, diagnostic method and treatment were alcohol consumption (44.0%), pharyngeal foreign body sensation (66.9%), hyperaemia (52.4%), pharyngolaryngitis (54.8%), pH monitoring (47.6%) and medication (82.1%), respectively. Only 28.3% of all participants knew that 24 h pH or multichannel intraluminal impedance pH monitoring was the most accurate diagnostic test. As many as 73.1% of all participants knew that proton pump inhibitors were the first-line treatment drugs. An analysis of the overall status of awareness using a scoring system suggested that otolaryngologists were better aware owing to more access, working at 3A hospitals, and postgraduate or above educational background (all p<0.05). CONCLUSION Although the majority of Chinese otolaryngologists had heard of LPRD, their overall awareness about the disease was not encouraging. More efforts are needed to increase the knowledge about LPRD among this group of physicians. TRIAL REGISTRATION NUMBER ChiCTR1900025581.
Collapse
Affiliation(s)
- Shuifang Xiao
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Jinrang Li
- Department of Otolaryngology, Head and Neck Surgery, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hongliang Zheng
- Department of Otolaryngology, Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Xiangping Li
- Department of Otolaryngology, Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hui Yang
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Junbo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Xiaoxia Peng
- Clinical Epidemiology and Evidence-based Medicine Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shuihong Zhou
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chen Zhao
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Donghui Chen
- Department of Otolaryngology, Head and Neck Surgery, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Xuping Xiao
- Department of Otolaryngology, Head and Neck Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Li Shi
- Department of Otolaryngology, Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi, China
| | - Hui Huangfu
- Department of Otolaryngology, Head and Neck Surgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Zhenfeng Tao
- Department of Otolaryngology, Head and Neck Surgery, Bethune International Peace Hospital, Shijiazhuang, Hebei, China
| | - Xiong Chen
- Department of Otolaryngology, Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yehai Liu
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Shenhong Qu
- Department of Otolaryngology, Head and Neck Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Guangke Wang
- Department of Otolaryngology, Head and Neck Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Ting Chen
- Department of Otolaryngology, Head and Neck Surgery, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Xiaobo Cui
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
| | - Linli Tian
- Department of Otolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Wensheng Zhou
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Hongyan Fang
- Department of Otolaryngology, Head and Neck Surgery, Chongqing General Hospital, Chongqing, China
| | - Yongwang Huang
- Department of Otolaryngology, Head and Neck Surgery, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Guodong Yu
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Zhenqun Lin
- Department of Otolaryngology, Head and Neck Surgery, Hainan Provincial People's Hospital, Haikou, Hainan, China
| | - Liang Tang
- Department of Otolaryngology, Head and Neck Surgery, The People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Jian He
- Department of Otolaryngology, Head and Neck Surgery, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Ruixia Ma
- Department of Otolaryngology, Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Zhaoyan Yu
- Department of Otolaryngology, Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong Provincial ENT Hospital Affiliated to Shandong University, Jinan, Shandong, China
| |
Collapse
|
15
|
Quach DT, Phan BT. A Long Duration of Reflux Symptoms is the Predominant Risk Factor for Depression in Vietnamese Patients with Gastroesophageal Reflux Disease. Neuropsychiatr Dis Treat 2022; 18:2141-2150. [PMID: 36176921 PMCID: PMC9514266 DOI: 10.2147/ndt.s381892] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/05/2022] [Indexed: 12/02/2022] Open
Abstract
PURPOSE Depression is more prevalent in patients with gastroesophageal reflux disease (GERD) than in controls. The disorder can worsen the quality of life of GERD patients and is also associated with poor treatment response. However, there are limited data on its prevalence and risk factors in GERD patients in Southeast Asia. We aimed to assess the prevalence and severity of depression and its associated factors in Vietnamese patients with GERD. PATIENTS AND METHODS A cross-sectional study was conducted on GERD patients. GERD was defined as troublesome typical reflux symptoms at least twice a week or having endoscopic erosive reflux disease. The revised Beck's Depression Inventory (BDI-IA), which has been locally validated, was used to evaluate depression (BDI-IA < 10: none, 10-18: mild to moderate, 19-29: moderate to severe, and ≥ 30: severe depression). Multiple logistic regression analysis was used to identify independent factors associated with depression. RESULTS A total of 194 patients were recruited. The mean age was 44.1 ± 12.0 years, and the male-to-female ratio was 1:1.2. The depression rate was 47.9% (mild to moderate: 30.9%, moderate to severe: 16.0%, and severe: 1.0%). In multivariate analysis, sex and duration of reflux symptoms were the only two risk factors for depression. Compared to males, females were more likely to suffer from depression: odds ratio (OR) = 3.941 (95% confidence interval [CI], 1.386-11.205), p = 0.010. Compared to patients with a duration of reflux symptoms < 1 year, those with a duration of 1-10 years and > 10 years were more likely to suffer from depression with a dose‒response: OR = 3.520 (95% CI, 1.057-11.717), p = 0.040; and OR = 5.605 (1.046-30.019), p = 0.044, respectively. CONCLUSION Depression was prevalent, and a long duration of reflux symptoms was its predominant risk factor in Vietnamese patients with GERD.
Collapse
Affiliation(s)
- Duc Trong Quach
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Binh Thanh Phan
- Department of Internal Medicine, Moc-Hoa Regional General Hospital, Long An, Vietnam
| |
Collapse
|
16
|
Wong MW, Liu TT, Yi CH, Lei WY, Hung JS, Cock C, Omari T, Gyawali CP, Liang SW, Lin L, Chen CL. Oesophageal hypervigilance and visceral anxiety relate to reflux symptom severity and psychological distress but not to acid reflux parameters. Aliment Pharmacol Ther 2021; 54:923-930. [PMID: 34383968 DOI: 10.1111/apt.16561] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/21/2021] [Accepted: 07/21/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The pathogenesis of gastro-oesophageal reflux disease (GERD) is complex and multifactorial. The oesophageal hypervigilance and anxiety scale (EHAS) is a novel cognitive-affective evaluation of visceral sensitivity. AIMS To investigate the interrelationship between EHAS and reflux symptom severity, psychological stress, acid reflux burden, phenotypes, and oesophageal mucosal integrity in patients with GERD. METHODS Patients with chronic reflux symptoms and negative endoscopy underwent 24-hour impedance-pH monitoring for phenotyping, acid reflux burden, and mucosal integrity with mean nocturnal baseline impedance (MNBI) calculation. Validated scores for patient-reported outcomes, including EHAS, GERD questionnaire (GERDQ), State-Trait Anxiety Inventory score, and Taiwanese Depression Questionnaire score, were recorded. RESULTS We enrolled 105 patients, aged 21-64 years (mean, 48.8), of whom 58.1% were female; 27 had non-erosive reflux disease, 43 had reflux hypersensitivity and 35 had functional heartburn. There were no significant differences in sex, EHAS, GERDQ, questionnaires of depression or anxiety among GERD phenotypes. EHAS was significantly correlated with GERDQ, questionnaires of depression and anxiety (P < 0.05). However, there were no significant correlations between GERDQ and questionnaires of depression or anxiety. Regarding patient-reported outcomes, GERDQ positively correlated with acid exposure time and negatively correlated with MNBI (P < 0.05). CONCLUSIONS EHAS associates with reflux symptom severity and psychological stress but not with acid reflux burden or mucosal integrity. Thus, EHAS assessment shows promise in assessment of subjective patient outcome and satisfaction with treatment, a hitherto unmet clinical need.
Collapse
Affiliation(s)
- Ming-Wun Wong
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.,School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Tso-Tsai Liu
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Chih-Hsun Yi
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Wei-Yi Lei
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Jui-Sheng Hung
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Charles Cock
- Department of Gastroenterology and Hepatology, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Taher Omari
- Department of Gastroenterology and Hepatology, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Chandra Prakash Gyawali
- Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Shu-Wei Liang
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Lin Lin
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Chien-Lin Chen
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.,Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| |
Collapse
|
17
|
Tseng WH, Hsu WC, Hsiao TY, Wu JF, Lee HC, Wang HP, Wu MS, Tseng PH. Anatomical and physiological characteristics in patients with Laryngopharyngeal Reflux Symptoms: A case-control study utilizing high-resolution impedance manometry. J Formos Med Assoc 2021; 121:1034-1043. [PMID: 34366184 DOI: 10.1016/j.jfma.2021.07.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/PURPOSE This study aimed to explore the anatomical and physiological characteristics of patients with laryngopharyngeal reflux (LPR) symptoms, such as hoarseness, throat clearing, throat pain, globus, and chronic cough, with the novel high-resolution impedance manometry (HRIM). METHODS Consecutive patients exhibited at least one LPR symptom for ≥4 weeks after 2-month proton-pump inhibitor treatment were enrolled during November 2014 and March 2018 from single tertiary medical center. All patients completed validated symptom questionnaires, esophagogastroduodenoscopy, and HRIM. Healthy volunteers were also recruited for comparison of esophageal parameters on HRIM. RESULTS Eighty-nine LPR patients and 63 healthy volunteers were analyzed. Compared with healthy volunteers, LPR patients had significantly shorter upper and lower esophageal sphincters (UES and LES), a shorter intraabdominal esophagus (all P < 0.01), higher 4-s integrated relaxation pressures (IRP-4s) (P = 0.011) of the LES. After adjusted for age, sex, body weight, body height and alcohol consumption, multiple regression analysis showed that age, LES IRP-4s and the UES length were independent risk factors for LPR symptoms (OR 1.056, 95% CI 1.019-1.094; OR 1.107, 95% CI 1.004-1.222; OR 0.432, 95% CI 0.254-0.736, respectively). In subgroup analysis, patients with moderate LPR symptoms had lower IRP-4s (6.64 ± 4.55 vs. 8.69 ± 5.10, P = 0.049) and more failed peristalsis (27.33 ± 29.26 vs. 11.36 ± 21.20, P = 0.004) than those with mild LPR symptoms. CONCLUSION Our study suggests that esophageal structural factors and LES IRP-4s may contribute to the occurrence of LPR symptoms. Patients with moderate LPR symptoms were more likely to present with failed peristalsis.
Collapse
Affiliation(s)
- Wen-Hsuan Tseng
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taiwan
| | - Wei-Chung Hsu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Tzu-Yu Hsiao
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jia-Feng Wu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Hui-Chuan Lee
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiu-Po Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ping-Huei Tseng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
18
|
Chen G, Liu W, Liao W, Song L, Yang P, Zhang X. An epidemiological survey of gastroesophageal reflux disease at the digestive endoscopy center in Guangzhou. Eur Arch Otorhinolaryngol 2021; 278:4901-4908. [PMID: 34291347 DOI: 10.1007/s00405-021-06999-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/13/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aims to investigate the detection rates, common symptoms and risk factors of gastroesophageal reflux disease (GERD), and laryngopharyngeal reflux disease (LPRD) at the digestive endoscopy center. METHODS A multicenter cross-sectional survey conducted at three hospitals and a total of 565 eligible participants were enrolled. All the patients completed routine ENT examination, gastroscopy, gastroesophageal reflux questionnaire (GerdQ), reflux symptom index (RSI) and a self-designed 25-item symptoms table survey. RESULTS Among the 565 eligible participants, the detection rates of GERD and LPRD were 18.41% (104/565) and 9.91% (56/565), respectively. The detection rate of GERD combined with LPRD was 3.19% (18/565). Among GERD and LPRD patients, males (vs. females), middle-aged and elderly patients (vs. young people), BMI ≥ 24.0 kg/m2 (vs. BMI < 24.0 kg/m2), with current smoking history (vs. no smoking), and current drinking history (vs. no drinking), lying down immediately after meal (vs. no lying down immediately after meal) were significantly higher (all p < 0.05). The most common extraesophageal symptoms in patients with GERD were dry mouth (66.35%), globus sensation (56.73%), dry throat and pharyngeal itching (55.77%). The most common extraesophageal symptoms in patients with LPRD were globus sensation (91.07%), dry throat and pharyngeal itching (83.93%), and dry mouth (82.14%). CONCLUSION GERD and LPRD had a high detection rate at the digestive endoscopy center in Guangzhou, China. Older age, BMI ≥ 24.0 kg/m2, smoking and drinking history were risk factors for both GERD and LPRD. Neither GerdQ nor RSI scores included common extraesophageal symptoms.
Collapse
Affiliation(s)
- Gui Chen
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, Laboratory of ENT-HNS Disease, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
| | - Weixing Liu
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, Laboratory of ENT-HNS Disease, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
| | - Wenjing Liao
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, Laboratory of ENT-HNS Disease, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
| | - Lijuan Song
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, Laboratory of ENT-HNS Disease, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
| | - Pingchang Yang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, Laboratory of ENT-HNS Disease, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China
| | - Xiaowen Zhang
- State Key Laboratory of Respiratory Disease, Department of Otolaryngology-Head and Neck Surgery, Laboratory of ENT-HNS Disease, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510120, China.
| |
Collapse
|
19
|
Lechien JR, Bobin F, Muls V, Saussez S, Hans S. Laryngopharyngeal Reflux Disease is More Severe in Obese Patients: A Prospective Multicenter Study. Laryngoscope 2021; 131:E2742-E2748. [PMID: 34086292 DOI: 10.1002/lary.29676] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES/HYPOTHESIS To investigate whether there is an impact of obesity and overweight on the clinical findings and therapeutic responses of patients with laryngopharyngeal reflux (LPR). STUDY DESIGN Prospective uncontrolled. METHODS Patients with LPR-related symptoms and positive LPR diagnosis at the hypopharyngeal-esophageal multichannel intraluminal impedance pH-monitoring (HEMII-pH) were recruited from December 2017 to December 2020. Patients were treated with a combination of diet, proton pump inhibitors, and alginate for 3 to 6 months. The following outcomes were studied according to the weight of patients: HEMII-pH, gastrointestinal endoscopy features, symptoms, findings, and therapeutic response. RESULTS A total of 262 patients completed the study, accounting for 134, 85, and 43 patients with normal weight (body mass index [BMI] <25), overweight (BMI = 25-29.99), and obesity (BMI >30). Obese patients reported significant higher prevalence of gastroesophageal reflux disease (GERD), acid LPR, and a more severe LPR disease regarding the number of pharyngeal reflux events, reflux symptom score (RSS), and reflux sign assessment (RSA). RSS and RSA scores significantly improved from baseline to 3-month posttreatment irrespective of the patient weight group. Symptoms and signs continued to improve from 3 to 6-month posttreatment only in patients with a normal weight. CONCLUSION Obesity is associated with a more severe LPR disease and a higher proportion of GERD and acid LPR. Obese LPR patients may require more frequently PPI-therapy regarding the higher prevalence of GERD. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
Collapse
Affiliation(s)
- Jerome R Lechien
- Research Committee, Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, University Paris Saclay, Paris, France.,Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | | | - Vinciane Muls
- Department of Gastroenterology, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Sven Saussez
- Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Stéphane Hans
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, University Paris Saclay, Paris, France
| |
Collapse
|
20
|
Lechien JR, Bobin F, Muls V, Mouawad F, Dequanter D, Horoi M, Thill MP, Rodriguez Ruiz A, Saussez S. The efficacy of a personalised treatment depending on the characteristics of reflux at multichannel intraluminal impedance-pH monitoring in patients with acid, non-acid and mixed laryngopharyngeal reflux. Clin Otolaryngol 2021; 46:602-613. [PMID: 33503317 DOI: 10.1111/coa.13722] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/16/2020] [Accepted: 01/16/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the evolution of symptoms and findings of laryngopharyngeal reflux (LPR) patients according to the type of reflux (acid, non-acid, mixed and gastro-oesophageal (GERD)). DESIGN Prospective uncontrolled multicentre study. METHODS One hundred and six patients with LPR have been recruited from 3 European Hospitals. According to the reflux characteristics at the impedance-pH monitoring (acid, non-acid, mixed, GERD), patients received a personalised treatment based on the association of diet, pantoprazole, alginate or magaldrate for 3 months. Reflux Symptom Score (RSS) was assessed at baseline, 6 and 12 weeks post-treatment. Reflux Sign Assessment (RSA) has been used to rate laryngeal and extra-laryngeal findings at baseline and 12 weeks post-treatment. Overall success rate and the evolution of symptoms and findings were evaluated according to the LPR types. RESULTS One hundred and two LPR patients (42 acid, 33 non-acid, 27 mixed, including 49 with LPR and GERD) completed the study. RSS and RSA total scores significantly improved from baseline to post-treatment time in acid, mixed and non-acid groups. The presence of GERD in addition to LPR did not impact the clinical improvement. The 3-month success rates of treatment ranged from 62% to 64%, and there were no significant differences between groups. The success rate of patients with non-acid LPR was similar to those of patients with mixed and acid LPR. CONCLUSION MII-pH is useful to specify the type of LPR and the related most adequate therapeutic regimen. Non-acid or mixed LPR similarly respond to treatment than acid LPR but require a treatment based on alginate or magaldrate covering the non-acid proximal reflux events.
Collapse
Affiliation(s)
- Jérôme R Lechien
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Francois Bobin
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, Polyclinique de Poitiers, Poitiers, France
| | - Vinciane Muls
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Gastroenterology and Endoscopy, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Francois Mouawad
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Lille, Université de Lille 2, Lille, France
| | - Didier Dequanter
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Mihaela Horoi
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Marie-Paule Thill
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexandra Rodriguez Ruiz
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Sven Saussez
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
21
|
Zhang Z, Bao YY, Zhou SH. Pump Proton and Laryngeal H +/K + ATPases. Int J Gen Med 2020; 13:1509-1514. [PMID: 33363399 PMCID: PMC7754099 DOI: 10.2147/ijgm.s284952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/20/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose The presence of extra-gastric H+/K+ ATPases may explain the clinically significant effect of proton pump inhibitor (PPI) pharmacotherapy in patients with chronic laryngitis related to laryngopharyngeal reflux disease (LPRD) but without gastroesophageal reflux disease (GERD) symptoms. Given the need for a better understanding of GERD and LPRD, we review the various proton pumps with respect to their classification, function, and distribution. We then consider the potential role of the laryngeal H+/K+ ATPase pump in LPRD. Methods We searched databases of PubMed, EMBASE, and Web of Science to achieve related published before September 15, 2020. Results There were only seven English-literatures meeting inclusive criteria about laryngeal H+/K+ ATPases. Some studies provide convincing evidence of a laryngeal H+/K+ ATPase in normal laryngeal tissues but also suggest the potential role of the proton pump in the abnormal mucus secretion frequently seen in patients with chronic laryngitis. Conclusion A laryngeal H+/K+ ATPase expresses in normal laryngeal tissues. These findings question the current understanding of GERD and LPRD.
Collapse
Affiliation(s)
- Zhe Zhang
- Department of Otolaryngology, Peoples Hospital of Yuyao City, Yuyao 315400, Zhejiang, People's Republic of China
| | - Yang-Yang Bao
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, People's Republic of China
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, People's Republic of China
| |
Collapse
|
22
|
Liu Y, Zhou P, Zhang S, Wu H, Yang Z, Xu M, Liu S, Wang Y. Association between gastroesophageal reflux disease and depression disorder: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22696. [PMID: 33120761 PMCID: PMC7581124 DOI: 10.1097/md.0000000000022696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND This study will systematically synthesize the evidence on the potential association between gastroesophageal reflux disease (GERD) and depression disorder (DD). METHODS We will search the following electronic bibliographic databases: PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, the Chinese Bio Medical Literature Database, China National Knowledge Infrastructure (CNKI), the China Science and Technology Journal database (VIP) and Wanfang Data. In addition, ongoing trials will be retrieved from the WHO ICTRP Search Portal, the Chinese Clinical Trial Register and The Clinical Trials Register. Articles related to gastroesophageal reflux disease and depression will be searched. And language and time will be unlimited. RESULTS The study will afford additional insight into the investigation the association between GERD and DD. CONCLUSIONS The results of this study will provide helpful evidence to explore the association between GERD and DD. REGISTRATION NUMBER INPLASY202090026.
Collapse
Affiliation(s)
- Yu Liu
- School of Pharmacy, Hebei University of Chinese Medicine
| | - Panpan Zhou
- Department of Gastroenterology, The First Affiliated Hospital of Hebei University of Chinese Medicine, Shijiazhuang, Hebei, P.R. China
| | - Shixiong Zhang
- School of Pharmacy, Hebei University of Chinese Medicine
| | - Huiqing Wu
- Department of Gastroenterology, The First Affiliated Hospital of Hebei University of Chinese Medicine, Shijiazhuang, Hebei, P.R. China
| | - Zeqi Yang
- School of Pharmacy, Hebei University of Chinese Medicine
| | - Miaochan Xu
- School of Pharmacy, Hebei University of Chinese Medicine
| | - Shaowei Liu
- School of Pharmacy, Hebei University of Chinese Medicine
| | - Yangang Wang
- Department of Gastroenterology, The First Affiliated Hospital of Hebei University of Chinese Medicine, Shijiazhuang, Hebei, P.R. China
| |
Collapse
|