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J Korean Soc Laryngol Phoniatr Logop > Volume 27(2); 2016 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2016;27(2): 78-83.
doi: https://doi.org/10.22469/jkslp.2016.27.2.78
식도 외 역류의 도그마
박일석
한림대학교 의과대학 동탄성심병원 이비인후과학교실
Dogma of Extraesophaghgeal Reflux
Il-Seok Park
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hallym University, Hwaseong, Korea
Correspondence  Il-Seok Park ,Tel: (031) 8086-2892, Fax: (031) 8086-2681, Email: ispark@hallym.or.kr
Received: 13 May 2016; Revised: May 13, 2016   Accepted: 19 May 2016.  Published online: 30 December 2016.
ABSTRACT
Laryngopharyngeal reflux (LPR) disease is an extraoesophageal variant of gastro-esophageal reflux disease that can affect the larynx and pharynx. LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.
KEY WORDS: Extraesophageal reflux diseaseLaryngopharyngeal refluxReflux laryngitis
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