Document Detail


Paroxysmal laryngospasm: a typical but underrecognized supraesophageal manifestation of gastroesophageal reflux?
MedLine Citation:
PMID:  15628718     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thirty-five consecutive adult patients with paroxysmal laryngospasm (LS) and with unimpaired vocal fold mobility were prospectively studied for coexisting gastroesophageal reflux disease (GERD). Nineteen patients reported frequent (>3 episodes a week) LS episodes (FLS patients) and 16 patients reported occasional LS episodes (OLS patients). All patients underwent an extensive otorhinolaryngological (ORL) examination, upper gastrointestinal (GI) endoscopy, ambulatory 24-hr dual-channel esophageal pH monitoring, and esophageal manometry. In addition, a subset of LS patients also underwent ambulatory duodenogastroesophageal reflux (DGER) monitoring. Patients with daily LS used the symptom marker during pH monitoring indicating separate LS episodes. All FLS patients and 14 OLS patients (87%) had a diagnosis of GERD. Only 10 patients (29%) experienced heartburn and/or regurgitation. Compared to OLS patients, FLS patients generally had more severe GERD as indicated by a higher prevalence of a hiatus hernia, higher distal and proximal esophageal acid exposure times, and higher values of DGER. In six FLS patients, 21 LS episodes (91%) occurred simultaneously with acid reflux, indicating a causal association between LS and GER. On antireflux therapy consisting of omeprazole, 20 mg bid, or lansoprazole, 30 mg oid, and lifestyle measures, LS ceased completely in all patients within 6 weeks. The present study not only demonstrates the role of GER in the pathogenesis of LS and the effectiveness of antireflux therapy, but also suggests that LS in adult patients with unimpaired vocal fold mobility might be considered a typical, although most frequently unrecognized, supraesophageal manifestation of GER.
Authors:
Johan Poelmans; Jan Tack; Louw Feenstra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  49     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:    2004 Nov-Dec
Date Detail:
Created Date:  2005-01-04     Completed Date:  2005-01-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1868-74     Citation Subset:  AIM; IM    
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
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MeSH Terms
Descriptor/Qualifier:
2-Pyridinylmethylsulfinylbenzimidazoles
Adult
Aged
Female
Gastroesophageal Reflux / complications*,  drug therapy
Humans
Laryngismus / drug therapy,  etiology*
Male
Middle Aged
Omeprazole / analogs & derivatives*,  therapeutic use
Prospective Studies
Proton Pumps / antagonists & inhibitors
Chemical
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Proton Pumps; 103577-45-3/lansoprazole; 73590-58-6/Omeprazole

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