Laryngopharyngeal Reflux, Oesophageal pH-impedance
Conditions
Brief summary
Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents into the larynx, pharynx and upper aerodigestive tract. The symptoms and manifestations are very changeable and non specific. Pharyngeal and Oesophageal pH-impedance may help to detect these reflux and to identify patients with abnormal LPR. To compare and describe the results of pharyngeal and oesophageal pH-impedance of patients with high suspicion of laryngopharyngeal reflux, with the results of healthy patients.
Detailed description
This is a monocentric, prospective descriptive study. Patients will be recruited in otolaryngology and gastroenterology departments of Bordeaux teaching hospital. A first clinical, endoscopic and pH-impedance evaluation will be made, after at least 15 days of interruption of any proton pump inhibitors (PPI). After 8 weeks' treatment by double PPI doses (esomeprazole 40 mg bid), another clinical and pH-impedance evaluation will be realized. The characteristics of the patients who respond to the treatment will be compared to non responders. The subjects will also have an initial laryngoscopy, an oesophageal manometry allowing the location of the lower sphincter of the oesophagus and the upper sphincter of the oesophagus for positioning the catheters.
Interventions
Patients with pharyngolaryngeal symptoms will have a clinical evaluation, laryngoscopy, and pharyngoesophageal pH-impedance. Then a treatment by esomeprazole during 8 weeks in the term of which the second clinical evaluation and pH-impedance will be made.
Sponsors
Study design
Eligibility
Inclusion criteria
* age : 18 to 80 years old. * Written consent * Laryngopharyngeal symptoms (dysphonia, and/or globus and/or sensation, and/or pharyngeal pain, and/or cough) for 3 months at least. * No PPI for at least 15 days * Social security affiliation
Exclusion criteria
* Sinusitis or chronic rhinitis (in the previous year) * Laryngeal trauma, tracheotomy or pharyngolaryngeal surgery * pregnancy or absence of efficacy contraception * breast feeding * history of gastrointestinal pathology, diabetes, neurological condition * cardio-vascular history requiring the taking of Plavix * esomeprazole contraindication or intolerance
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of pharyngeal reflux/24h | visit 3 - 60 days after inclusion |
| • Number of pharyngeal acid reflux/24h | Visit 3 - 60 days after inclusion |
| • Number of pharyngeal less acid reflux/24h | Visit 3 - 60 days after inclusion |
| • Pharyngeal acid exposure (% of total time with pharyngeal pH <4) | Visit 3 - 60 days after inclusion |
| • Pharyngeal bolus exposure (% of total time with liquid in the pharynx) | Visit 3 - 60 days after inclusion |
Countries
France