Esophagopharyngeal reflux

Abstract

OBJECTIVE: Laryngopharyngeal reflux (LPR) is the disorder caused by the regurgitation of gastric contents into the laryngopharynx. Many persons diagnosed with LPR who fail medical therapy regurgitate contents from the proximal esophagus into the laryngopharynx (esophagopharyngeal reflux or EPR) on cinefluoroscopy. STUDY DESIGN: Retrospective review. SUBJECTS AND METHODS: The charts of consecutive adult patients with findings of EPR on cinefluoroscopy were reviewed. RESULTS: Twenty patients met the diagnostic criteria for EPR (mean age, 50 years of age; 60% female). Most common symptoms were cough (40%), dysphagia (35%), dysphonia (25%), and chronic throat clearing (25%). Eighty-five percent had a prior diagnosis of acid reflux disease (LPR or GER) and were unsuccessfully treated with proton pump inhibitors and/or anti-reflux surgery; 15% had fluoroscopic oropharyngeal abnormalities; all patients had fluoroscopic esophageal abnormalities. CONCLUSION: EPR is characterized by regurgitation of proximal esophageal contents into the laryngopharynx. The symptoms are similar to LPR. EPR appears to be caused by a disorder of volume clearance and esophageal dysmotility not acid and peptic injury.