Laryngopharyngeal reflux (LPR) – when gastric contents refluxes into the larynx/pharynx – can be diagnosed using a salivary pepsin test, says a study published in the International Archives of Otorhinolaryngology.

Pepsin is an enzyme in gastric juice that can damage the laryngeal mucosa, even at mild acidic or alkaline pH.

The current mainstay of the diagnosis of LPR is a combination of symptoms, fibreoptic endoscopic findings and 24-hour multichannel intraluminal impedance (MII) combined with double-probe pH monitoring (MII-pH).

However, MII-pH monitoring is invasive, time consuming and not available in many medical centres, with many patients finding the process intolerable.

This latest study has evaluated the predictive value of salivary pepsin in diagnosing LPR and concluded that it is a ‘useful test in the diagnosis of laryngopharyngeal reflux disease’.

120 patients were recruited for the study by the Department of ENT at the City Hospital in Kerala, India with common symptoms of throat irritation, globus sensation (the feeling of a lump in the throat), dry cough and regurgitation.

Researchers say the study indicates that salivary pepsin test is ‘indeed a very useful test in the diagnosis of LPR, especially in a set up in which MII-pH is not available.

A positive pepsin test in combination with the Reflux Score Indicator (a scoring system based on how many symptoms of reflux disease a person has and how troublesome those symptoms are), the Reflux Finding Score and trial of response to treatment revealed ‘significant association’.

Download and read research paper.


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