Jerome R Lechien1,2,3,4, Francois Bobin5,6, Vinciane Muls5,7, Mihaela Horoi8, Marie-Paule Thill8, Didier Dequanter5,8, Alexandra Rodriguez5,8, Sven Saussez5,9,8. 1. Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France. Jerome.Lechien@umons.ac.be. 2. Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium. Jerome.Lechien@umons.ac.be. 3. Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Avenue du Champ de mars, 6, B7000, Mons, Belgium. Jerome.Lechien@umons.ac.be. 4. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium. Jerome.Lechien@umons.ac.be. 5. Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France. 6. Polyclinique Elsan de Poitiers, Poitiers, France. 7. Department of Gastroenterology, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium. 8. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium. 9. Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
Abstract
OBJECTIVE: To assess the impact of diet on the occurrence of proximal reflux episodes at the multichannel intraluminal impedance-pH monitoring (MII-pH) in patients with laryngopharyngeal reflux (LPR). METHODS: Patients with LPR symptoms and findings were recruited from three European hospitals. The LPR diagnostic was confirmed through MII-pH and patients were benefited from gastrointestinal (GI) endoscopy. Regarding the types of reflux at the MII-pH (acid, nonacid, mixed), patients received a 3 month-therapy based on the association of alkaline, low-fat and high-protein diet, proton pump inhibitors, alginate or magaldrate. Reflux symptom score (RSS) and reflux sign assessment (RSA) were used to evaluate laryngeal and extra-laryngeal symptoms and findings from pretreatment to posttreatment. The Global Refluxogenic Score (GRES) was used to assess the refluxogenic potential of the diet of the patients at baseline and posttreatment. The relationship between GRES severity; the MII-pH findings; GI endoscopy; and the therapeutic response was explored through multiple linear regression. RESULTS: Eighty-five LPR patients were included. The mean GRES significantly improved from pretreatment (50.7 ± 23.8) to posttreatment (27.3 ± 23.2; P = 0.001). Similarly, RSS and RSA significantly improved from baseline to posttreatment. The baseline GRES was significantly associated with the occurrence of proximal reflux episodes at the MII-pH (P = 0.001). Trends were found regarding the association between GRES and the occurrence of esophagitis (P = 0.06) and between hiatal hernia and DeMeester score (P = 0.06). There was a significant and strong association between the concomitant respect of diet and medication and the improvement of RSS (P = 0.001). CONCLUSION: The consumption of high-fat, low-protein, high-sugar, acid foods, and beverages is associated with a higher number of proximal reflux episodes at the MII-pH, according to the global refluxogenic score of LPR patients.
OBJECTIVE: To assess the impact of diet on the occurrence of proximal reflux episodes at the multichannel intraluminal impedance-pH monitoring (MII-pH) in patients with laryngopharyngeal reflux (LPR). METHODS:Patients with LPR symptoms and findings were recruited from three European hospitals. The LPR diagnostic was confirmed through MII-pH and patients were benefited from gastrointestinal (GI) endoscopy. Regarding the types of reflux at the MII-pH (acid, nonacid, mixed), patients received a 3 month-therapy based on the association of alkaline, low-fat and high-protein diet, proton pump inhibitors, alginate or magaldrate. Reflux symptom score (RSS) and reflux sign assessment (RSA) were used to evaluate laryngeal and extra-laryngeal symptoms and findings from pretreatment to posttreatment. The Global Refluxogenic Score (GRES) was used to assess the refluxogenic potential of the diet of the patients at baseline and posttreatment. The relationship between GRES severity; the MII-pH findings; GI endoscopy; and the therapeutic response was explored through multiple linear regression. RESULTS: Eighty-five LPR patients were included. The mean GRES significantly improved from pretreatment (50.7 ± 23.8) to posttreatment (27.3 ± 23.2; P = 0.001). Similarly, RSS and RSA significantly improved from baseline to posttreatment. The baseline GRES was significantly associated with the occurrence of proximal reflux episodes at the MII-pH (P = 0.001). Trends were found regarding the association between GRES and the occurrence of esophagitis (P = 0.06) and between hiatal hernia and DeMeester score (P = 0.06). There was a significant and strong association between the concomitant respect of diet and medication and the improvement of RSS (P = 0.001). CONCLUSION: The consumption of high-fat, low-protein, high-sugar, acid foods, and beverages is associated with a higher number of proximal reflux episodes at the MII-pH, according to the global refluxogenic score of LPR patients.
Authors: Jerome R Lechien; Anaïs Rameau; Lisa G De Marrez; Gautier Le Bosse; Karina Negro; Andra Sebestyen; Robin Baudouin; Sven Saussez; Stéphane Hans Journal: Eur Arch Otorhinolaryngol Date: 2022-06-28 Impact factor: 2.503
Authors: Alexandra Rodriguez; Stéphane Hans; Jerome R Lechien; Sven Saussez; Géraldine Nowak; Lise Crevier-Buchman; Marta P Circiu Journal: Eur Arch Otorhinolaryngol Date: 2022-02-25 Impact factor: 2.503
Authors: Afrin N Kamal; Shumon I Dhar; Thomas L Carroll; Lee M Akst; Jonathan M Bock; John O Clarke; Jerome R Lechien; Jacqueline Allen; Peter C Belafsky; Joel H Blumin; Walter W Chan; Ronnie Fass; P Marco Fisichella; Michael Marohn; Ashli K O'Rourke; Gregory Postma; Edoardo V Savarino; Michael F Vaezi Journal: Dig Dis Sci Date: 2022-08-22 Impact factor: 3.487
Authors: Amanda J Krause; Erin H Walsh; Philip A Weissbrod; Tiffany H Taft; Rena Yadlapati Journal: Ann N Y Acad Sci Date: 2021-12-17 Impact factor: 6.499
Authors: Jerome R Lechien; Sven Saussez; Vinciane Muls; Maria R Barillari; Carlos M Chiesa-Estomba; Stéphane Hans; Petros D Karkos Journal: J Clin Med Date: 2020-11-10 Impact factor: 4.241
Authors: Jerome R Lechien; Stéphane Hans; Francois Bobin; Christian Calvo-Henriquez; Sven Saussez; Petros D Karkos Journal: J Clin Med Date: 2021-05-31 Impact factor: 4.241