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Laryngopharyngeal Reflux: Symptoms, Signs, and Presence of Pepsin in Saliva - A Reliable Diagnostic Triad.
Divakaran, Shilpa; Rajendran, Sivaa; Thomas, Roshan Marie; Jacob, Jaise; Kurien, Mary.
Afiliação
  • Divakaran S; Department of ENT, NMC Specialty Hospital, Muscat, Oman.
  • Rajendran S; Department of Biochemistry, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India.
  • Thomas RM; Department of ENT, City Hospital , Kochi, Kerala, India.
  • Jacob J; Department of Biochemistry, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India.
  • Kurien M; Department of Biochemistry, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India.
Int Arch Otorhinolaryngol ; 25(2): e273-e278, 2021 Apr.
Article em En | MEDLINE | ID: mdl-33968232
Introduction Twenty-four-hour multichannel intraluminal impedance with double probe pH monitoring (MII-pH), though considered the most sensitive tool for the diagnosis of gastroesophageal reflux disease (GERD), is invasive, time consuming, not widely available, and unable to detect non-acid reflux. In contrast, the presence of pepsin in the saliva would act as a marker for reflux, considering that pepsin is only produced in the stomach. Objective To evaluate the predictive value of salivary pepsin in diagnosing laryngopharyngeal reflux (LPR) as suggested by the results of reflux symptom index (RSI > 13), reflux finding score (RFS > 7), and positive response to treatment with a 4-week course of proton-pump inhibitors. Methods This prospective study was done at a tertiary care hospital on 120 adult patients attending ENT OPD with clinical diagnosis of LPR. The presence of pepsin in their pharyngeal secretions and saliva using a lateral flow device, the Peptest, was compared with RSI, RFS, and with the response to medical treatment using the Chi-squared test. Results Salivary pepsin was found to be positive in 68% of the patients, with 87.5% of them showing positive response to treatment. Chi-squared analysis showed a significant association between positive salivary pepsin and RFS > 7, RSI >13, a combination of RFS > 7 and RSI > 13 as well as with response to treatment ( p < 0.0001). Conclusion When considered along with the clinical indicators of RFS and RSI of more than 7 and 13, respectively, and/or with a response to treatment, a positive salivary pepsin test indicates statistically significant chance of presence of LPR.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Int Arch Otorhinolaryngol Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Omã País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Int Arch Otorhinolaryngol Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Omã País de publicação: Brasil