Salivary Pepsin versus Oesophageal PH Metry as a Diagnostic Test for Laryngopharyngeal Reflux Disease
Tarek Mohamed Yousif, Manal Sabry Mohammed, Tary Magdy Aziz Geogre, Ahmed Mohammed Mahmoud Mostafa- General Medicine
Abstract
Background
Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents (acid and enzymes such as pepsin) into the laryngopharynx leading to symptoms referable to the larynx/hypopharynx.
Objective
To evaluation of salivary pepsin as a non-invasive rapid test for diagnosis of laryngopharyngeal reflux versus oesophageal ph metry.
Patients and Methods
This was a prospective comparative study conducted on 50 subjects; to evaluate the salivary pepsin as a non-invasive rapid test for diagnosis of laryngo-pharyngeal reflux (LPR) versus oesophageal pH metry.
Results
The increase in age, laryngoscopic abnormality, and pH metry; had an independent effect on increasing salivary Pepsin; with significant statistical difference (p < 0.05 respectively). The increase in laryngoscopic abnormality; had an independent effect on increasing pH metry (% Time pH < 4); with significant statistical difference (p = 0.00002). The increase in pH metry (% Time pH < 4); had an independent effect on increasing the probability of LPR occurrence; with significant statistical difference (p < 0.005). Salivary Pepsin at a cutoff point (>5) predicted patients with LPR, with fair (77.9%) accuracy, sensitivity= 100% and specificity= 56% (p = 0.0001). PH metry (% Time pH < 4) at a cutoff point (>14) predicted patients with LPR, with good (87%) accuracy, sensitivity= 80% and specificity= 100% (p < 0.0001).
Conclusion
In this study we have shown that pepsin in saliva of patients with LPR is significantly higher than normal individuals, this may help as a diagnostic tool without using invasive methods for diagnosis of LPR.