Fatores associados aos sintomas laríngeos atribuídos ao refluxo gastroesofágico em pacientes com laringite posterior

Detalhes bibliográficos
Ano de defesa: 2015
Autor(a) principal: Ponte, Cynthia Aben-Athar
Orientador(a): Não Informado pela instituição
Banca de defesa: Não Informado pela instituição
Tipo de documento: Tese
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://www.repositorio.ufc.br/handle/riufc/14286
Resumo: This study aimed to evaluate the influence of esophageal motility parameters, the characteristics of gastroesophageal reflux, the presence of anxiety and depression, the presence of dyspeptic symptoms and the gastric emptying on the laryngeal symptoms (hoarseness, throat clearing and coughing) in patients with posterior laryngitis attributed to GERD. Initially, we studied 20 patients with posterior larynx and typical symptoms of GERD and 12 patients with erosive reflux esophagitis without laryngeal symptoms. All patients underwent upper endoscopy, high-resolution manometry and answered the questionnaire of GERD symptoms (QS-GERD) and the questionnaire about quality of life in GERD (QVRS-DRGE). Then, only the group of patients with laryngitis underwent 24 hours impedance-pH monitoring, answered Hospital Anxiety and Depression Scale (HADS) and the questionnaire of Porto Alegre of dyspeptic symptoms (PADYQ) and underwent gastric emptying breath test. All protocols were approved by the Research Ethics Committee of HUWC (14464214.8.0000.5045). Data were analyzed using the unpaired Student t test, Mann-Whitney and the correlation of Spearman. Endoscopy was normal in 85% of patients with laryngitis. The need to use medication had greater impact on the quality of life of the group with esophagitis, while the degree of dissatisfaction with their situation was significantly higher in patients with laryngitis. Patients presented with laryngitis had pressure of the lower esophageal sphincter and contractility of the esophageal body significantly larger than esophagitis group. There was no correlation between esophageal motility parameters with the frequency of laryngeal symptoms (hoarseness, throat clearing and coughing) in the laryngitis group. There was a positive correlation between the frequency of symptoms of hoarseness, throat clearing and coughing with the number of reflux measured by impedance-pH monitoring. This correlation was found only with weakly acidic reflux (4.0 6.5) for symptoms throat clearing and cough. There was a high prevalence of anxiety / depression in patients with laryngitis (50%), with a positive correlation between the intensity of anxiety and the frequency of hoarseness and , but not coughing. Patients with laryngitis showed a high prevalence of gastrointestinal symptoms (75%), but it was not observed delay in gastric emptying of solids in this group when compared to normal subjects. From this results we conclude that the laryngeal symptoms attributed to gastroesophageal reflux are associated with a greater degree of dissatisfaction with clinical situation and loss in quality of life; with the presence of weakly acidic or alkaline reflux and with anxiety. It was unrelated to endoscopic mucosal injury , changes in esophageal motility and gastric emptying .