Scientific Unit for Clinical and Medical Research, Osijek University Hospital
Abstract
Laringofarinksni refluks (LPR) i gastroezofagusni refluks (GER) dva su različita klinička entiteta, dvije različite bolesti koje se razlikuju po simptomima, kliničkim manifestacijama, mehanizmu nastanka refluksa, različitim dijagnostičkim kriterijima i terapijskom pristupu. Osnovni simptomi LPR-a su ovi: promuklost, kronično čišćenje grla, postnazalni drip, teškoće gutanja, suhi kašalj, teškoće s disanjem, a samo 6 do 11% bolesnika ima žgaravicu, podrigivanje, pečenje iza prsne kosti i osjećaj vraćanja želučanoga sadržaja u grlo. Osnovni su klinički znakovi LPR-a: pseudosulkus vokalis, ventrikularna obliteracija, eritem u grkljanu, edem glasnica, difuzni laringalni edem, hipertrofija stražnje komisure, granulomi/granulacije, gusti endolaringalni mukus. Dijagnoza se temelji na kombinaciji kliničkih simptoma i znakova bolesti, 24-satnoj pH-metriji, višekanalnoj intraluminalnoj impedanciji i detekciji pepsina u slini. U terapiji se primjenjuju inhibitori protonske pumpe u dvokratnoj dozi.Laryngopharyngeal refux and gastroesophageal reflux are two different clinical entities, two different diseases which differ in symptoms, clinical manifestations, mechanism of reflux, diagnostic criteria and therapeutic schedules. Main symptoms of LPR are hoarseness, clearing of throat, postnasal drip, swallowing difficulties, coughing, breathing difficulties and in only 6 to 11 % of patients heartburn, chest pain, indigestion or stomach acid coming up. Main clinical signs of LPR are: pseudosulcus vocalis, ventricular obliteration, erythema/hyperemia, vocal fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulations and thin endolaryngeal mucus. The diagnosis is usually based on a combination of diagnostic signs and symptoms, 24-hour pH-metry, multichannel intraluminal impedance and pepsin in saliva. In therapy proton pump inhibitors are being applied twice a day
