Laryngopharyngeal reflux diagnostics: review article

Abstract

Laryngopharyngeal reflux (LPR) is an actual, modern problem for the practice of an ENT doctor, because majority of complaints lead the patient, first of all, to an otorhinolaryngologist. LPR is an extraesophageal manifestation of gastroesophageal reflux disease (GERD), which leads to a recurrent course of symptoms resulting from the direct action of gastric contents on the mucous membrane of the laryngopharynx when ingested through the upper esophageal sphincter, as well as a decrease in the quality of life. Patients with LPR represent 4% to 10% of outpatients visiting an ENT physician. The main problem of diagnosing of LPR is that there are not any exact researches for this disease, such as PCR-test or biopsy. GERD diagnostic methods performed by gastroenterologists include: assessment of complaints, esophagogastroduodenoscopy (EGDS), intraesophageal pH-metry, esophageal manometry, impedance-pH-metry with the placement of 2 probes in the esophagus and pharynx, gastrointestinal fluoroscopy (GI) with barium, gastroesophageal scintigraphy, abdominal ultrasound (abdominal ultrasound), and pepsin test. All these tests are widely using for diagnosis and sometimes helps us. But the question remains: do all these research methods allow to establish the presence of LPR? Interpretation of existing studies is difficult due to the ambiguous diagnostic criteria for LPR, varying rates of response to treatment, and the significant effect of placebo treatment. Therefore, diagnostic methods for LFR require further study and development.