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. 2021 Feb;131(2):350-359.
doi: 10.1002/lary.28756. Epub 2020 Jun 8.

Saliva Pepsin Concentration of Laryngopharyngeal Reflux Patients Is Influenced by Meals Consumed Before the Samples

Jerome R Lechien  1   2   3   4 , Francois Bobin  1   5 , Vinciane Muls  1   6 , Mihaela Horoi  4 , Marie-Paule Thill  4 , Didier Dequanter  1   4 , Camille Finck  1   7 , Alexandra Rodriguez #  1   4 , Sven Saussez #  1   2   4
Affiliations

Saliva Pepsin Concentration of Laryngopharyngeal Reflux Patients Is Influenced by Meals Consumed Before the Samples

Jerome R Lechien et al. Laryngoscope. 2021 Feb.

Abstract

Objectives/hypothesis: To assess the impact of diet on the saliva pepsin concentration of patients with laryngopharyngeal reflux (LPR).

Study design: Non-controlled Prospective Study.

Methods: Patients with positive LPR regarding hypopharyngeal-esophageal impedance-pH monitoring (HEMII-pH) were enrolled from three European Hospitals. Patients collected three saliva samples, respectively, in the morning (fasting), and 1 to 2 hour after lunch and dinner. Patients carefully detailed foods and beverages consumed during meals and before the pepsin samples. The 3-month treatment was based on the association of diet, proton pump inhibitors, alginate, or magaldrate regarding the HEMII-pH characteristics. Reflux Symptom Score (RSS) and Reflux Sign Assessment (RSA) were used for assessing the pre- to posttreatment clinical evolution. The Refluxogenic Diet Score and the Refluxogenic Score of a Dish (RESDI) were used to assess the refluxogenic potential of foods and beverages. The relationship between saliva pepsin concentration, HEMII-pH, RESDI, RSS, and RSA was investigated through multiple linear regression.

Results: Forty-two patients were included. The saliva pepsin concentration of the 24-hour period of testing was significantly associated with foods and beverages consumed during the testing period and the evening dinner (rs = 0.973, P < .001). RSS and RSA significantly improved throughout treatment. The level of saliva pepsin in the morning was a negative predictive factor of the therapeutic response regarding RSA and RSS (P < .036).

Conclusions: Foods and beverages may significantly impact the saliva pepsin concentration of patients with LPR. Patients with high-level saliva pepsin in the morning had lower therapeutic response compared with those with low-level saliva pepsin.

Level of evidence: 4 Laryngoscope, 131:350-359, 2021.

Keywords: Reflux; beverages; diet; foods; laryngitis; laryngopharyngeal; pepsin; saliva.

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References

BIBLIOGRAPHY

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