Clinical Analysis of Gastroesophageal Reflux Disease Manifested Mainly as Stubborn Pharyngitis_West China Medical Journal

Authors：

 CHENXia , LIANGHong-liang , CHENXu-ping , FUDan

Department of Gastroenterology, the Sixth People's Hospital of Chengdu, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

Keywords：

Gastroesophageal reflux disease; Stubborn pharyngitis; Sucralfate suspension; Esomeprazole

DOI：

10.7507/1002-0179.20140269

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Objective To explore and analyze the clinical diagnosis and treatment of gastroesophageal reflux disease (GERD) which is manifested mainly as stubborn pharyngitis. Methods From February 2010 to December 2012, 79 cases were diagnosed as stubborn pharyngitis and otolaryngology standard treatment was invalid. GERD questionnaire ratings and conventional endoscopy were performed for patients with obvious manifestations of stubborn pharyngitis shown on the laryngoscopy. They were randomly divided into treatment group (n=40) and control group (n=39). Patients in the treatment group accepted esomeprazole 40 mg, qd, for 12 weeks; and patients in the control group had sucralfate suspension 15 mL bid for 12 weeks. At the three observation points which are 4, 8, and 12 weeks after treatment began, clinical symptom score and pharyngeal inflammatory changes were recorded, and at the end of the treatment, all patients underwent endoscopy, and esophageal mucosal healing was observed. Results There was no significant difference between the two groups of patients in terms of general data. After the treatment, the symptom scores were significantly decreased in the treatment group at the three observation points (P<0.05). The same situation happened also in the control group, but the difference was not significant (P>0.05). The symptom scores between the two groups after treatment were significantly different (P<0.5). And the effective rate for local pharyngeal infection was 83.9% and 41.4% in the treatment group and the control group respectively (P<0.05). Conclusion Some atypical GERDs feature by the symptoms of stubborn pharyngitis. Clinically, patients with long-term stubborn pharyngitis should be screened to exclude the possibility of GERD. esomeprazole therapy can significantly improve the pharyngitis symptoms and relieve local inflammation.

Citation： CHENXia, LIANGHong-liang, CHENXu-ping, FUDan. Clinical Analysis of Gastroesophageal Reflux Disease Manifested Mainly as Stubborn Pharyngitis. West China Medical Journal, 2014, 29(5): 886-889. doi: 10.7507/1002-0179.20140269 Copy

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3.	中国胃食管反流病研究协作组. 反流性疾病问卷在胃食管反流病诊断中的价值[J]. 中华消化杂志, 2003, 23(11):7-10.
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7.	Vaezi MF, Hicks DM, Abelson TI, et al. Laryngeal signs and symptoms and gastroesophageal reflux disease (GERD):a critical assessment of cause and effect association[J]. Clin Gastroenterol Hepatol, 2003, 1(5):333-344.
8.	龚齐, 周康年. 反流性咽喉炎与胃食管反流病的关系研究[J]. 临床耳鼻咽喉科杂志, 2001, 15(12):548-549.
9.	贾文学, 许秋荣, 任晓华, 等. 胃食管反流病与慢性咽炎的关系研究[J]. 河北医药, 2010, 32(22):3137-3138.
10.	王建军, 朱峰, 王仁杰. 以咽喉炎为主要表现的胃食管反流病35例临床分析[J]. 中国煤炭工业医学杂志, 2006, 9(10):1041-1042.
11.	王晓巍, 倪道凤. 胃食管反流与慢性咽喉炎[J]. 中华耳鼻咽喉科杂志, 2004, 39(1):55-58.
12.	Akman C, Riviello JJ, Madsen JR, et al. Pharyngeal dysesthesia in refractory complex partial epilepsy:new seizure or adverse effect of vagal nerve stimulation?[J]. Epilepsia, 2003, 44(6):855-858.
13.	Kamel P, Kahrilas PJ, Hanson DG, et al. Prospective trial of omeprazole in treatment of reflux laryngitis[J]. Gastroenterelogy, 1992, 202(Supp1):A93.
14.	李晓华, 孙建设, 曾斌, 等. 以顽固性咽喉症状为主诉的胃食管反流病46例临床分析[J]. 江西医学院学报, 2007, 47(6):91-92.
15.	汪菁峰, 袁耀宗, 许斌, 等. 胃食管反流病食管外症状-咽喉炎的临床研究[J]. 中华消化杂志, 2006, 26(1):6-9.

1. Vakil N, Van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease:a global evidence-based consensus[J]. Am J Gastroenterol, 2006, 101(8):1900-1920.
2. Fass R, Ofman JJ. Gastroesophageal reflux disease-should we adopt a new conceptual framework?[J]. Am J Gastroenterol, 2002, 97(8):1901-1909.
3. 中国胃食管反流病研究协作组. 反流性疾病问卷在胃食管反流病诊断中的价值[J]. 中华消化杂志, 2003, 23(11):7-10.
4. Hirano I, Richter JE. Practice parameters committee of the American college of gastroenterology. ACG practice guidelines:esophageal reflux testing[J]. Am J Gastroenterol, 2007, 102(3):668-685.
5. 张澍田. 胃食管反流病的发病机制[J]. 北京中医药, 2008, 27(3):165-166.
6. Sharma P, Dent J, Armstrong D, et al. The development and validation of an endoscopic grading system for Barrett's esophagus:the Prague C & M criteria[J]. Gastroenterology, 2006, 131(5):1392-1399.
7. Vaezi MF, Hicks DM, Abelson TI, et al. Laryngeal signs and symptoms and gastroesophageal reflux disease (GERD):a critical assessment of cause and effect association[J]. Clin Gastroenterol Hepatol, 2003, 1(5):333-344.
8. 龚齐, 周康年. 反流性咽喉炎与胃食管反流病的关系研究[J]. 临床耳鼻咽喉科杂志, 2001, 15(12):548-549.
9. 贾文学, 许秋荣, 任晓华, 等. 胃食管反流病与慢性咽炎的关系研究[J]. 河北医药, 2010, 32(22):3137-3138.
10. 王建军, 朱峰, 王仁杰. 以咽喉炎为主要表现的胃食管反流病35例临床分析[J]. 中国煤炭工业医学杂志, 2006, 9(10):1041-1042.
11. 王晓巍, 倪道凤. 胃食管反流与慢性咽喉炎[J]. 中华耳鼻咽喉科杂志, 2004, 39(1):55-58.
12. Akman C, Riviello JJ, Madsen JR, et al. Pharyngeal dysesthesia in refractory complex partial epilepsy:new seizure or adverse effect of vagal nerve stimulation?[J]. Epilepsia, 2003, 44(6):855-858.
13. Kamel P, Kahrilas PJ, Hanson DG, et al. Prospective trial of omeprazole in treatment of reflux laryngitis[J]. Gastroenterelogy, 1992, 202(Supp1):A93.
14. 李晓华, 孙建设, 曾斌, 等. 以顽固性咽喉症状为主诉的胃食管反流病46例临床分析[J]. 江西医学院学报, 2007, 47(6):91-92.
15. 汪菁峰, 袁耀宗, 许斌, 等. 胃食管反流病食管外症状-咽喉炎的临床研究[J]. 中华消化杂志, 2006, 26(1):6-9.

West China Medical Journal

Clinical Analysis of Gastroesophageal Reflux Disease Manifested Mainly as Stubborn Pharyngitis

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