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1
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The use of RSI and RFS questionnaires in the Polish language version

100%
Włodarczyk E., Miaśkiewicz B., Szkiełkowska A., Skarzyński P., Skarżyński H.
Otolaryngologia Polska
|
2019
|
vol. 73(1)
17-21
EN
RSI and RFS questionnaires are a basic and common method used for initial diagnosis of laryngopharyngeal reflux (LPR). However, they only measure symptoms which may or may not be concurrent with LPR. The severity of these symptoms is assessed either by the patients themselves (with the use of the Reflux Symptoms Index – RSI) or by the doctor specialising in the field (with the use of the Reflux Finding Score – RFS). Therefore, the findings of the questionnaire may to a large extent depend on the study population – its demographic and cultural characteristics; the extent to which the medical terms used in the questionnaires are understood; and on the linguistic aspects and translation choices. As for the Polish language versions of these questionnaires, there is no reliable analysis of their consistency and if they reach the assumed goal. The studies we have conducted on a group of 84 patients show that we encounter at least one of the above-mentioned problems. Therefore, to make the questionnaires reliable and useful for diagnosis, it is necessary to conduct a formal validation of their translation and to conduct studies on reference groups.
2
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Protection and regeneration of esophageal, pharyngeal, and laryngeal mucosa as a major element in therapy of patients with esophageal and extraesophageal reflux symptoms

100%
Gąsiorowska A.
Polish Journal of Otolaryngology
|
2020
|
vol. 74
|
issue 4
40-45
EN
Treatment of esophageal and extraesophageal reflux syndromes is mainly focused on inhibiting the secretion of hydrochloric acid. In spite of the high efficacy of proton pump inhibitors, approx. 30–60% of GERD patients experience daily symptoms. Beside acid reflux, other factors such as abnormal esophageal peristalsis, visceral hypersensitivity, ineffective esophageal clearance mechanisms, and impaired mucosal barrier also play an important role in generating GERD symptoms. An additional therapeutic proposition is a procedure aimed at improving the defense mechanisms of esophageal mucosa rather than inhibiting the damage-inducing factors. The preparation consisting of hyaluronic acid (HA), chondroitin sulfate (SC) and poloxamer 407 protects against harmful factors (hydrochloric acid, pepsin) and accelerates mucosal healing and regeneration, constituting a substantial element of monotherapy or add-on therapy in patients with gastroesophageal reflux disease.
3
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The role of pepsin in the laryngopharyngeal reflux

100%
Kowalik K., Krzeski A.
Otolaryngologia Polska
|
2017
|
vol. 71(6)
7-13
EN
Laryngopharyngeal reflux (LPR) is a common defect among laryngological and phoniatric patients. Although LPR is categorized as a superficial gastroesophageal reflux disease (GERD), differential diagnosis should treat these two diseases separately. LPR symptoms can be assessed in the interview using as a tool the reflux symptom index (RSI). In addition, changes in the larynx that occur during LPR might be seen during laryngoscopy and classified according to the reflux finding score (RFS). One of the main mucosal irritants in LPR is pepsin which digests proteins and impairs the functions of the upper respiratory tract cells by affecting carbonate anhydrase (CAIII) and the Sep 70 protein. Pepsin initiates inflammatory changes within the larynx, nasopharynx and nasal cavity. The use of pepsin detection in upper and lower throat secretions is a new direction in LPR diagnostics.
4
Publication available in full text mode
Content available

Protection and regeneration of esophageal, pharyngeal, and laryngeal mucosa as a major element in therapy of patients with esophageal and extraesophageal reflux symptoms

100%
Gąsiorowska A.
Otolaryngologia Polska
|
2020
|
vol. 74(4)
40-45
EN
Treatment of esophageal and extraesophageal reflux syndromes is mainly focused on inhibiting the secretion of hydrochloric acid. In spite of the high efficacy of proton pump inhibitors, approx. 30–60% of GERD patients experience daily symptoms. Beside acid reflux, other factors such as abnormal esophageal peristalsis, visceral hypersensitivity, ineffective esophageal clearance mechanisms, and impaired mucosal barrier also play an important role in generating GERD symptoms. An additional therapeutic proposition is a procedure aimed at improving the defense mechanisms of esophageal mucosa rather than inhibiting the damage-inducing factors. The preparation consisting of hyaluronic acid (HA), chondroitin sulfate (SC) and poloxamer 407 protects against harmful factors (hydrochloric acid, pepsin) and accelerates mucosal healing and regeneration, constituting a substantial element of monotherapy or add-on therapy in patients with gastroesophageal reflux disease.
5
Publication available in full text mode
Content available

The role of pepsin in the laryngopharyngeal reflux

100%
Kowalik K., Krzeski A.
Polish Journal of Otolaryngology
|
2017
|
vol. 71
|
issue 6
7-13
EN
Laryngopharyngeal reflux (LPR) is a common defect among laryngological and phoniatric patients. Although LPR is categorized as a superficial gastroesophageal reflux disease (GERD), differential diagnosis should treat these two diseases separately. LPR symptoms can be assessed in the interview using as a tool the reflux symptom index (RSI). In addition, changes in the larynx that occur during LPR might be seen during laryngoscopy and classified according to the reflux finding score (RFS). One of the main mucosal irritants in LPR is pepsin which digests proteins and impairs the functions of the upper respiratory tract cells by affecting carbonate anhydrase (CAIII) and the Sep 70 protein. Pepsin initiates inflammatory changes within the larynx, nasopharynx and nasal cavity. The use of pepsin detection in upper and lower throat secretions is a new direction in LPR diagnostics.
6
Publication available in full text mode
Content available

Applicability of RSI and RFS questionnaires in the Polish language version

100%
Włodarczyk E., Miaśkiewicz B., Szkiełkowska A., Skarzyński P., Skarżyński H.
Polish Journal of Otolaryngology
|
2019
|
vol. 73
|
issue 1
17-21
EN
RSI and RFS questionnaires are a basic and common method used for initial diagnosis of laryngopharyngeal reflux (LPR). However, they only measure symptoms which may or may not be concurrent with LPR. The severity of these symptoms is assessed either by the patients themselves (with the use of the Reflux Symptoms Index – RSI) or by the doctor specialising in the field (with the use of the Reflux Finding Score – RFS). Therefore, the findings of the questionnaire may to a large extent depend on the study population – its demographic and cultural characteristics; the extent to which the medical terms used in the questionnaires are understood; and on the linguistic aspects and translation choices. As for the Polish language versions of these questionnaires, there is no reliable analysis of their consistency and if they reach the assumed goal. The studies we have conducted on a group of 84 patients show that we encounter at least one of the above-mentioned problems. Therefore, to make the questionnaires reliable and useful for diagnosis, it is necessary to conduct a formal validation of their translation and to conduct studies on reference groups.
7
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Laryngological symptoms of gastroesophageal reflux disease

88%
Mierzwa G., Sinkiewicz A.
Polski Przegląd Otorynolaryngologiczny
|
2017
|
vol. 6(2)
70-75
EN
The artical presents a case of a 32 years old men with extraoesophagal symptoms of gastroesohagal reflux disease and laryngopharyngeal reflux. He was by ph-impedance monitoring, stroboskopy and gastrointestinal endoscopy with biopsy diagnosed. PPI therapy with dexlansoprasole was most efficient.
8
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The role of an oral formulation of hyaluonic acid and chondroitin sulphate in the treatment of patients with laryngopharyngeal reflux

75%
Chmielecka-Rutkowska J., Tomasik B., Pietruszewska W.
Otolaryngologia Polska
|
2019
|
vol. 73(6)
38-49
EN
Introduction: Proton pump inhibitors (PPIs) have become an important breakthrough in the treatment of gastroesophageal reflux disease (GERD). However, in patients with laryngopharyngeal reflux (LPR) – one of the extraesophageal variants of the disease – the efficacy of PPI is incomplete or limited and alleviation of symptoms requires additional medications. As of today, the importance of hyaluronic acid (HA) and chondroitin sulphate (CS) and their role in mucosal damage healing, most particularly within the larynx, is being highlighted. Objective: The objective of the study was to assess the outcomes of treatment in LPR patients receiving a combination of hyaluronic acid and chondroitin sulfate (HA + CS) on a bioadhesive carrier. Material and methods: A total of 51 patients (18 males and 33 females) aged 25–75 years and presenting with LPR symptoms further confirmed in a laryngovideoscopic examination, were included in the study. Patients were qualified for the study on the basis of reflux symptom index (RSI) of above 13 and reflux finding score (RFS) of above 7. Patients were recommended to use the HA + CS combination product for 14 days and were evaluated after this time. Results: Symptoms suggestive of significant or severe problem (RSI of 4 or 5) before the treatment included: throat clearing (48 patients; 90.19%), hoarseness (29 patients; 56.86%) and cough after eating/cough while lying down (37 patients; 72.50%). After the treatment, patients reported a moderate impact of the above symptoms on their everyday functioning (P < 0.001). Symptoms such as pharyngeal mucus presence, acute cough, sensation of foreign body in the throat, while declared as moderate at baseline (score of 3) resolved to mild (score of 1) following the supportive treatment (P < 0.001). Total RSI after the treatment was assessed as borderline for LPR diagnosis (median 13, range 12–15). Although patients were not completely freed of their reflux symptoms, a significant reduction in symptoms was achieved in the entire study group. Prior to the treatment, the most common morphological changes within the larynx included redness/congestion, vocal fold edema and posterior commissure hypertrophy. These changes were observed in all patients. After the treatment, the RFS fell below the LPR diagnostic threshold (median 6, range 5–7). Compared to baseline values (median 9, range 8–10), significant improvement of laryngeal changes was observed in nearly the entire study group (N = 50; 98.04%) (P < 0.001). Conclusions: The combination product consisting of hyaluronic acid and chondroitin sulfate on a bioadhesive acts locally to significantly reduce laryngopharyngeal reflux symptoms, particularly in patients with chronic cough, throat clearing, and hoarseness. In addition, by lining the laryngeal mucosa with a protective layer, the product facilitates better hydration as well as faster healing and regeneration of the mucosal membrane, thus leading to a reduction or resolution of morphological changes within the larynx.
9
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Extraesophageal manifestations of gastroesophageal reflux disease – pathophysiology, diagnosis and management

75%
Dobrzyński P., Ziuzia L.
Polski Przegląd Otorynolaryngologiczny
|
2016
|
vol. 5(2)
26-45
EN
Gastroesophageal reflux disease (GERD) is defined as a condition in which the reflux of stomach contents causes troublesome symptoms and/or complications. This common disease may also present with atypical, extraesophageal symptoms. Laryngopharyngeal reflux (LPR) is the reflux of gastric contents into the throat and larynx, which causes symptoms such as globus, throat clearing, hoarseness and chronic cough. GERD and LPR may be related to many dis-eases, including laryngitis, asthma, COPD, chronic rhinosinusitis, otitis media, dental erosions, and even laryngeal cancer or life-threatening events. The diagnosis of LPR is based on clinical symptoms (measured by RSI), laryngoscop-ic signs (evaluated in RFS), an empiric trial of proton pomp inhibitor (PPI) therapy, 24-hour pH monitoring, impedance monitoring, esophageal manometry and endoscopic examination. The most common management is double-dose PPI therapy for at least six months. When this treatment is ineffective, the surgery should be considered. However, di-agnosis and treatment of LPR is still controversial. Further studies are necessary to establish an optimal algorithm for the management of LPR.
10
Publication available in full text mode
Content available

The role of an oral formulation of hyaluonic acid and chondroitin sulphate in the treatment of patients with laryngopharyngeal reflux

75%
Chmielecka-Rutkowska J., Tomasik B., Pietruszewska W.
Polish Journal of Otolaryngology
|
2019
|
vol. 73
|
issue 6
38-49
EN
Introduction: Proton pump inhibitors (PPIs) have become an important breakthrough in the treatment of gastroesophageal reflux disease (GERD). However, in patients with laryngopharyngeal reflux (LPR) – one of the extraesophageal variants of the disease – the efficacy of PPI is incomplete or limited and alleviation of symptoms requires additional medications. As of today, the importance of hyaluronic acid (HA) and chondroitin sulphate (CS) and their role in mucosal damage healing, most particularly within the larynx, is being highlighted. Objective: The objective of the study was to assess the outcomes of treatment in LPR patients receiving a combination of hyaluronic acid and chondroitin sulfate (HA + CS) on a bioadhesive carrier. Material and methods: A total of 51 patients (18 males and 33 females) aged 25–75 years and presenting with LPR symptoms further confirmed in a laryngovideoscopic examination, were included in the study. Patients were qualified for the study on the basis of reflux symptom index (RSI) of above 13 and reflux finding score (RFS) of above 7. Patients were recommended to use the HA + CS combination product for 14 days and were evaluated after this time. Results: Symptoms suggestive of significant or severe problem (RSI of 4 or 5) before the treatment included: throat clearing (48 patients; 90.19%), hoarseness (29 patients; 56.86%) and cough after eating/cough while lying down (37 patients; 72.50%). After the treatment, patients reported a moderate impact of the above symptoms on their everyday functioning (P < 0.001). Symptoms such as pharyngeal mucus presence, acute cough, sensation of foreign body in the throat, while declared as moderate at baseline (score of 3) resolved to mild (score of 1) following the supportive treatment (P < 0.001). Total RSI after the treatment was assessed as borderline for LPR diagnosis (median 13, range 12–15). Although patients were not completely freed of their reflux symptoms, a significant reduction in symptoms was achieved in the entire study group. Prior to the treatment, the most common morphological changes within the larynx included redness/congestion, vocal fold edema and posterior commissure hypertrophy. These changes were observed in all patients. After the treatment, the RFS fell below the LPR diagnostic threshold (median 6, range 5–7). Compared to baseline values (median 9, range 8–10), significant improvement of laryngeal changes was observed in nearly the entire study group (N = 50; 98.04%) (P < 0.001). Conclusions: The combination product consisting of hyaluronic acid and chondroitin sulfate on a bioadhesive acts locally to significantly reduce laryngopharyngeal reflux symptoms, particularly in patients with chronic cough, throat clearing, and hoarseness. In addition, by lining the laryngeal mucosa with a protective layer, the product facilitates better hydration as well as faster healing and regeneration of the mucosal membrane, thus leading to a reduction or resolution of morphological changes within the larynx.
11
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Difficult management of chronic cough

75%
Dąbrowska M., Arcimowicz M.
|
EN
Chronic cough affects about 4–10% of adults and has a negative impact on the patients’ quality of life. Chronic cough may be a symptom of many different diseases and its management should be based on treating the underlying cause. The most common cough cause in adults is chronic bronchitis due to smoking. Next, in non-smoking adults upper airway cough syndrome, gastroesophageal reflux and asthma account for the majority of cough reasons. Despite thorough diagnostics and management in 5–10% adults management of chronic cough is unsuccessful. In difficult-to-treat cough neuromodulators and speech therapy may be effective.
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