|
| |||||||
|
Calabrese F, Pasta A, Giannini EG, Della Casa D, Cataudella G, Frazzoni M, Savarino EV, Penagini R, De Bortoli N, Savarino V, Marabotto E. The role of laryngoscopy in GERD patients with atypical symptoms - a multicentre study. UEGJour PosterPr.2023.11(S8)
The role of laryngoscopy in GERD patients with atypical symptoms - a multicentre study F. Calabrese1, A. Pasta1, E.G. Giannini1, D. Della Casa2, G. Cataudella3, M. Frazzoni4, E.V. Savarino5, R. Penagini6, N. De Bortoli7, V. Savarino8, E. Marabotto1
1 University of Genoa, Department of Internal Medicine and Medical Specialities, Genova, Italy, 2 Ospedale Civile di Brescia, Brescia, Italy, 3 Gastroenterology, Bassano Del Grappa, Italy, 4 Baggiovara Hospital, Digestive Pathophysiology Unit, Modena, Italy, 5 University of Padua, Division of Gastroenterology, Department of Surgery, Oncology And Gastroenterology, Padua, Italy, 6 Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy, 7 University of Pisa, Department of Translational Research and New Technologies in Medicine and Surgery, Pisa, Italy, 8 University of Genoa, Dept Internal Medecine, Genova, Italy Contact E-Mail Address: calabrese.francesco.93@ gmail.com Introduction: Gastroesophageal reflux disease (GERD) patients with atypical symptoms represents a diagnostic and therapeutic challenge. In particular, the diagnosis of GERD is often suspected by ENT surgeons according to laryngoscopic findings, but their sensitivity and specificity for diagnosis is low. The aim of this study was to assess the prevalence of GERD in patients with atypical symptoms undergoing laryngoscopic examination and pH monitoring. Aims & Methods: We retrospectively evaluated patients with atypical symptoms with or without typical symptoms associated referred to Gastroenterology Units of six tertiary Italian centres between January and December 2020. Of 477 patients, we enrolled 277 patients who underwent both 24 hours pH-impedance monitoring off-therapy and laryngoscopy. Diagnosis of GERD was made according to Lyon Consensus, and we considered the novel impedance metrics (baseline impedance and post reflux swallow-induced peristaltic wave index) when pH-impedance monitoring was inconclusive in order to add confidence to diagnosis of GERD. Three patients with hypersensitive esophagus were excluded. Results: The most common atypical symptom was cough (90/274). Laryngoscopic examination showed pathological findings in 195 patients (71.2%), and the most frequent feature detected was posterior laryngitis (77.4%). GERD was diagnosed in 80/274 patients (29.2%) on pH impedance monitoring. Upper endoscopy was made in 269 patients and 5 of them had B grade esophagitis. The prevalence of GERD diagnosis in patients with or without positive laryngoscopy examination was not statistically significant (p=0.075). No difference in the number of proximal refluxes was observed in patients with positive or negative laryngoscopy (65/195, 33.3% vs 19/79, 24.1%; p= 0.133). Sensitivity and specificity of laryngoscopy in diagnosing GERD is 78.8% and 32.0% respectively (PPV= 32.3%; NVP= 28.4%). Conclusion: Laryngoscopic examination has a poor specificity in diagnosing GERD in patients with atypical symptoms. This study may underline that pathological laryngoscopy findings could only pose a suspect of an underlying GERD, but its diagnosis would still need to be confirmed by impedance-pH monitoring, even in patients with atypical symptoms. Disclosure: Nothing to disclose. Calabrese F, Pasta A, Giannini EG, Della Casa D, Cataudella G, Frazzoni M, Savarino EV, Penagini R, De Bortoli N, Savarino V, Marabotto E. The role of laryngoscopy in GERD patients with atypical symptoms - a multicentre study. United European Gastroenterology Journal. 2023. V. 11(S8). Poster Presentations. PP0118. P.599. Сокращённый перевод (М. Юрченко): Роль ларингоскопии у пациентов с ГЭРБ с атипичными симптомами.
Введение. Пациенты с гастроэзофагеальной рефлюксной болезнью (ГЭРБ) с атипичными симптомами представляют собой сложную диагностическую и терапевтическую проблему. В частности, диагноз ГЭРБ часто предполагают по данным ларингоскопии, но такой диагноз имеет низкую чувствительность и специфичность.
|
Подборка статей с аннотациями на русском языке: Современные достижения зарубежной гастроэнтерологии. |
|