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Contemporary evaluation and management of Laryngopharyngeal reflux (LPR) - Research Paper Example

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Larypharyngeal reflux can be described as,‘The back flow of gastric contents to the laryngopharynx and upper aerodigestive tract’.This disease was previously considered to be a subset of gastroesophageal reflux disease,however,it is now recognized as a specific clinical entity,albeit with considerable overlap…
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Contemporary evaluation and management of Laryngopharyngeal reflux (LPR)

Download file to see previous pages... Larypharyngeal reflux can be described as,‘The back flow of gastric contents to the laryngopharynx and upper aerodigestive tract’ (Bulmer, 2010).This disease was previously considered to be a subset of gastroesophageal reflux disease (GERD), however, it is now recognized as a specific clinical entity, albeit with considerable overlap. Since its recognition, a notable quantity of research has been devoted to elucidating the pathogenesis of LPR, and establishing criteria and/or guidelines for the most relevant investigations and most effective management options. Although consensus has not been reached globally on these issues, generalized conclusions can be made through evidence in the literature that can guide physicians dealing with LPR patients. This paper seeks to summarize what is currently known and understood regarding laryngopharyngeal reflux. It begins with a brief historical narrative on the disease and its significance from a public health perspective, followed by a discussion of the underlying pathophysiologic mechanisms. It then reviews the literature recently published on its evaluation and management options. In conclusion, it states why it is important to recognize the disease, and reiterates the most reliable evidence in the literature regarding its diagnosis and treatment. ...
Furthermore, a number of reviews have been published over the years, and recently in 2011 as well, that discuss the results of several studies in combination. This review incorporates the discussion from those reviews, therefore, the individual studies that sourced those reviews have not been delved into. The ultimate aim was to provide an overview that is as contemporary as possible. Discussion Overview and History Reflux of gastric contents upwards into the esophagus and beyond, giving rise to the feeling of heartburn and taste of regurgitation, has long been recognized as an illness termed ‘gastroesophageal reflux disease’ (GERD). The concept of gastric reflux with resultant esophageal mucosal injury was recognized as early as 1935. Effects of reflux on the throat, such as cough, were also recognized, indeed, cough was considered a significant symptom of GERD. However, it was not until 1968 that Cherry and Margulies described the role of gastroesophageal reflux in laryngeal disease (Schreiber, 2009). Physicians eventually came to recognize that the significant effects of reflux on the larynx seemed to produce a different set of symptoms than those experienced in simple GERD. In 1987, Ossakow et al. conducted a study showing that patients with persistent cervical complaints frequently had acid reflux (68%) and poor acid clearance (79%) confirmed by esophageal manometrics and acid reflux testing, however, they did not commonly report complaints of pyrosis or regurgitation (Ossakow, 1987). Symptoms of LPR do not typically include the heartburn that is classic in GERD, and include hoarseness, sore throat, frequent throat clearing or globus sensation (Zerbib, 2010). The American Academy of Otolaryngology formally adopted the term ...Download file to see next pagesRead More
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