loading page

Characteristics of 24-h multichannel intraluminal impedance-pH monitoring in patients with laryngopharyngeal reflux refractory to proton pump inhibitor therapy: A prospective cohort study
  • +4
  • Su Il Kim,
  • Su Jin Jeong,
  • Oh Eun Kwon,
  • Jung Min Park,
  • Young Chan Lee,
  • Young Gyu Eun,
  • Seong-Gyu Ko
Su Il Kim
Myongji Hospital

Corresponding Author:[email protected]

Author Profile
Su Jin Jeong
Kyung Hee University Medical Center
Author Profile
Oh Eun Kwon
Kyung Hee University Medical Center
Author Profile
Jung Min Park
Kyung Hee University Medical Center
Author Profile
Young Chan Lee
Kyung Hee University Medical Center
Author Profile
Young Gyu Eun
Kyung Hee University Medical Center
Author Profile
Seong-Gyu Ko
Kyung Hee University
Author Profile

Abstract

Objectives: This study evaluated the characteristics of reflux in patients with laryngopharyngeal reflux (LPR) refractory to proton pump inhibitor (PPI) therapy using the 24-h multichannel intraluminal impedance (MII)-pH monitoring. Design: Prospective cohort study. Setting: A tertiary care otolaryngology clinic. Participants: Patients with suspected LPR underwent 24-hour MII-pH monitoring and were prescribed high-dose PPI twice daily. One-hundred and eight patients followed up for at least 2 months were enrolled. Main outcome measures: Patients with suspected LPR showing more than one proximal reflux episode were considered to have LPR. Patients with LPR showing ≥50% decrease in the follow-up reflux symptom index (RSI) score compared to the pre-treatment RSI score during treatment periods were defined as responders; others were defined as non-responders. Various parameters in the 24-h MII-pH monitoring between non-responders and responders with LPR were compared using Student’s t-test. Results: Of 108 patients with suspected LPR, 80 were diagnosed with LPR. Patients with LPR were categorized as non-responders (n = 19) and responders (n = 61). Proximal all reflux time and proximal longest reflux time in MII parameters were significantly higher in responders than in non-responders (p = 0.0040 and 0.0216, respectively). The proximal all reflux time >0.000517% was a better cut-off value to predict responders with LPR compared to the proximal longest reflux time >0.61 min (sensitivity + specificity: 1.317 vs. 1.291). Conclusions: The proximal all reflux time can be helpful to predict the response to PPI therapy and establish a personalized therapeutic scheme in patients with LPR.