24-Hour Multichannel Intraluminal Impedance–pH in Proton Pump Inhibitor Nonresponders vs Responders in Patients With Laryngopharyngeal Reflux

Su Il Kim, Su Jin Jeong, Oh Eun Kwon, Jung Min Park, Young Chan Lee, Young Gyu Eun, Seong Gyu Ko

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Objective: This study aimed to evaluate the characteristics of reflux in proton pump inhibitor (PPI) nonresponders vs responders in patients with laryngopharyngeal reflux (LPR) by using 24-hour multichannel intraluminal impedance–pH (MII-pH) monitoring. Study Design: Prospective cohort study. Setting: A tertiary care otolaryngology clinic. Methods: Patients with typical LPR symptoms showing >1 proximal reflux episode were considered to have LPR and investigated prospectively. Patients were prescribed high-dose PPI twice daily and followed up for at least 2 months. Patients with LPR showing a ≥50% decrease in the follow-up reflux symptom index score during treatment periods as compared with pretreatment were defined as responders; others were defined as nonresponders. Various parameters in 24-hour MII-pH monitoring between nonresponders and responders with LPR were compared with Student’s t test and receiver operating characteristic curve. Results: Eighty patients were diagnosed with LPR and categorized as nonresponders (n = 19) and responders (n = 61). Proximal all reflux time and proximal longest reflux time in various MII parameters were higher in responders than in nonresponders (P =.0040 and.0216, respectively). Proximal all reflux time >0.000517% was a better cutoff value to predict responders with LPR as compared with the proximal longest reflux time >0.61 minutes (sensitivity + specificity: 1.317 vs 1.291). Conclusion: Proximal all reflux time in various 24-hour MII-pH monitoring parameters can be helpful to predict the response to PPI therapy in patients with LPR. These findings will help establish a personalized therapeutic scheme for patients with LPR.

Original languageEnglish
Pages (from-to)910-916
Number of pages7
JournalOtolaryngology - Head and Neck Surgery
Volume166
Issue number5
DOIs
Publication statusPublished - May 2022

Keywords

  • laryngopharyngeal reflux
  • multichannel intraluminal impedance–pH (MII-pH)
  • nonresponder
  • proton pump inhibitor

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