Document Detail

The role of (duodeno)gastroesophagopharyngeal reflux in unexplained excessive throat phlegm.
MedLine Citation:
PMID:  15906752     Owner:  NLM     Status:  MEDLINE    
Gastroesophageal reflux (GER), through the occurrence of gastroesophagopharyngeal reflux (GEPR), is an established cause of several otorhinolaryngological (ORL) manifestations. It has been suggested that unexplained excessive throat phlegm might also be a manifestation of GER, but formal evidence is lacking. The aim of the present study was to investigate the prevalence of GER as well as duodenogastroesophageal reflux (DGER) in consecutive patients with chronic complaints of excessive throat phlegm. Fifty-nine consecutive patients with chronic unexplained excessive throat phlegm, transparent in 33 patients (TTP) and yellow in 26 patients (YTP), underwent gastrointestinal endoscopy, 24-hr dual esophageal pH monitoring, and fiberoptic DGER monitoring. Proximal esophageal DGER monitoring was performed in seven YTP patients and analysis of bile acids in throat phlegm was performed on 16 samples. The effect of high-dose acid suppressive therapy was evaluated at 2-week intervals. Endoscopy and pH monitoring established a diagnosis of pathological GER in 75% of the patients. Pathological DGER was present in 56% of the patients and this was associated with YTP. Proximal DGER exposure was high in all investigated subjects and chemical analysis revealed a median bile acid concentration of 0.184 microM in nine YTP samples and no detectable bile acids in seven TTP samples. After a median of 4 weeks of acid suppressive therapy, most patients improved and 61% became asymptomatic. YTP patients were more likely to require maintenance acid suppressive therapy than TTP patients. Unexplained excessive throat phlegm is a sign suggestive of GER and GEPR, and unexplained yellow throat phlegm a sign suggestive of duodenogastroesophagopharyngeal reflux (DGEPR).
J Poelmans; L Feenstra; J Tack
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  50     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-23     Completed Date:  2005-06-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  824-32     Citation Subset:  AIM; IM    
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals, Leuven, Belgium.
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MeSH Terms
Anti-Ulcer Agents / therapeutic use
Chronic Disease
Duodenogastric Reflux / complications*,  pathology,  physiopathology
Endoscopy, Gastrointestinal
Esophagus / physiopathology
Gastric Acidity Determination
Gastroesophageal Reflux / complications*,  pathology,  physiopathology
Hydrogen-Ion Concentration
Middle Aged
Mucus / physiology*
Pharynx / pathology*,  physiopathology*
Prospective Studies
Reg. No./Substance:
0/Anti-Ulcer Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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