GASTROENTEROLOGY ARTICLE OF THE WEEK

May 3, 2001 

 1.  Laryngeal injury by acid and pepsin

a.  occurs only when the laryngeal apparatus is exposed to continuous large amounts of acid and pepsin

b.  may be caused by minute amount of acid and pepsin as the normal mechanisms to protect against chemical injury are not present in the larynx

c.  may be caused by repeated cough and throat-clearing generated by distal-esophageal stimulation by acid

d.  histologically resembles the changes seeing in esophageal biopsies of     patients with reflux esophagitis 

True or False

 2.  Most studies have shown that patients with reflux laryngitis experience more acid reflux in the proximal esophagus compared to controls

 3.  Patients with reflux laryngitis typically have a classical history of gastroesophageal reflux.

 4.  ENT symptoms of reflux laryngitis may take 3 or more months to improve with adequate acid reducing therapy

 5.  The most common finding on laryngoscopy in patients with reflux laryngitis is laryngeal edema, which is easily missed with fiberoptic laryngoscopy

 6.  Patients with reflux laryngitis

            a.  often do not complain of heartburn

            b.  have a high prevalence of erosive esophagitis on endoscopy

            c.  should all undergo upper endoscopy

d.  may be diagnosed with pharyngeal pH monitoring, the presence of any amount of esophagopharyngeal acid reflux indicates a pathologic condition

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