Relationship between history, laryngoscopy and esophagogastroduodenoscopy for diagnosis of laryngopharyngeal reflux in patients with typical GERD.

The techniques used in the diagnosis of gastroesophageal reflux disease (GERD) have insufficient specificity and sensitivity in diagnosing laryngopharyngeal reflux (LPR). The purpose of this study was to evaluate the role of esophagogastroduodenoscopy (EGD) and laryngological examination in the diagnosis of LPR. A total of 684 diagnosed GERD and suspected LPR patients were prospectively scored by the reflux finding score (RFS) which was suggested by Koufman. A total of 484 patients with GERD who had RFS ≥ 7 were accepted as having LPR. 248 patients with GERD plus LPR on whom an endoscopic examination was performed were evaluated. As a control group, results from 82 patients with GERD who had RFS <7 were available for comparison. The GERD symptom score (RSS) was counted according to the existence of symptoms (heartburn/regurgitation) and frequency, duration, and severity. The reflux symptom index (RSI) suggested by Belafsky et al. was also evaluated. The relationship between esophageal endoscopic findings, RSS, RFS and RSI was investigated. Mean age was 46 ± 12 (19-80). The mean values of RSS, RFS, and RSI were 18.9 ± 7.7, 10 ± 2.2, 16.6 ± 11.9, respectively. Erosive esophagitis was detected in 75 cases (30%). Hiatus hernia was observed in 32 patients (13%). There was no correlation between RSS and RFS, RSI. The severity of esophagitis did not correlate with the severity of the laryngeal findings. LPR should be suspected when the history and laryngoscopy findings are suggestive of the diagnosis. EGD has no role in the diagnosis of LPR.