Prevalence and clinical predictors of LPR among patients diagnosed with GERD according to the reflux symptom index questionnaire

Abstract

Background/Aims: Gastroesophageal reflux disease (GERD) is a common condition that can lead to significant morbidity. Laryngopharyngeal reflux (LPR) is a distinct clinical entity that can occur simultaneously with GERD, necessitating additional treatment measures. The degree of overlap and clinical predictors of LPR among patients with GERD remains unknown. We aim to measure the prevalence of LPR in patients with GERD and identify clinical predictors. Patients and Methods: We performed a cross-sectional study involving patients with confirmed GERD according to the GERD questionnaire (GerdQ) using the reflux symptom index (RSI). Data on demographics, comorbidities, past and current medications, and GERD-related lifestyle measures were documented. The prevalence of LPR was calculated. Linear and logistic regression analyses were conducted to correlate GerdQ and RSI, and to identify clinical predictors of LPR, respectively. Results: A total of 80 patients with confirmed GERD were consecutively recruited and surveyed. Mean age was 43 (±16) and 60% were females. The majority of patients were Saudis (51%) and only 24% were smokers. The mean duration of GERD was 7 (±4.4) years and the average body mass index (BMI) was 36 ± 22. Sixty-six percent of the patients consumed coffee on regular basis. On simple and multiple linear regression analyses, a strong, positive correlation was observed between the GerdQ and RSI scores (coefficient = 1.13, 95%CI = 0.39–1.86), and ipratropium bromide inhaler was positively associated with RSI scores (coefficient = 13.12, 95%CI = 0.16–26.09). LPR was identified in 57 patients (71%). On simple and multiple logistic regression analyses, GerdQ scores (OR = 1.78, 95%CI = 1.13–2.80), BMI (OR = 1.07, 95%CI = 1.01–1.14), duration of GERD in years (OR = 1.42, 95%CI = 1.04–1.93), and the type of gender (OR = 49.67, 95%CI = 1.32–1870) appeared to increase the risk of LPR, whereas coffee consumption (OR = 0.0005, 95%CI = 1.82e–06, 0.13) appeared to be negatively associated with LPR. Conclusions: Contradictory to what is frequently reported, LPR commonly occurs and positively correlates with GERD. Several modifiable clinical predictors of LPR might exist, which highlight the importance of performing a complete clinical assessment of the patients with reflux symptoms.

Keywords

• Correlation
• gastroesophageal reflux disease
• laryngopharyngeal reflux
• severity