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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2015; 21(3): 982-987
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.982
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.982
New aspects in the pathomechanism and diagnosis of the laryngopharyngeal reflux-clinical impact of laryngeal proton pumps and pharyngeal pH metry in extraesophageal gastroesophageal reflux disease
Valentin Becker, Romina Drabner, Simone Graf, Christoph Schlag, Simon Nennstiel, Roland M Schmid, Dieter Saur, Monther Bajbouj, II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, 81675 München, Germany
Anna Maria Buchberger, Hals-Nasen Ohren Klinik, Klinikum rechts der Isar, Technische Universität München, 81675 München, Germany
Author contributions: Becker V, Bajbouj M and Schmid RM are responsible for the study design; Becker V, Bajbouj M, Schlag C and Nennstiel S performed patient recruitment; Drabner R and Saur D was immunohistochemistry and histopathology; Graf S and Buchberger AM performed ENT diagnostics.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Valentin Becker, II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, 22 Ismaninger str., 81675 München, Germany. valentin.becker@lrz.tum.de
Telephone: +49-89-41405847 Fax: +49-89-41404816
Received: July 15, 2014
Peer-review started: July 16, 2014
First decision: August 15, 2014
Revised: August 22, 2014
Accepted: October 14, 2014
Article in press: October 15, 2014
Published online: January 21, 2015
Peer-review started: July 16, 2014
First decision: August 15, 2014
Revised: August 22, 2014
Accepted: October 14, 2014
Article in press: October 15, 2014
Published online: January 21, 2015
Core Tip
Core tip: The pathophysiology and objective diagnosis of laryngopharyngeal reflux (LPR) is still unclear. The response to standard therapy (proton pump inhibitors) is poor. Laryngeal proton pumps (H+K+-ATPase) are often considered to be potential causes of LPR. The clinical significance of laryngeal proton pumps (H+K+-ATPase) is unclear. We present the first prospective series evaluating the laryngeal H+K+-ATPase, pharyngeal pH and symptom scores in patients with LPR symptoms. Laryngeal H+K+-ATPases can only be sporadically detected, and they are unlikely to cause LPR symptoms. The role of pharyngeal pH-metry remains unclear and its use can only be recommended for patients in the research study setting.