Pepsin Detection in Saliva As Non-Invasive Rapid Diagnostic Test For Laryngopharyngeal Reflux

Abstract

Back ground: Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents (acid and enzymes such as pepsin) into the laryngopharynx leading to symptoms referable to the larynx or hypopharynx. Ambulatory 24-hour double probe pH monitoring is the most widely used tool for the diagnosis. However, pH monitoring has some disadvantages, such as being an invasive, expensive and difficult to apply method. Therefore, more specific, non-invasive and cost effective diagnostic methods are needed for the diagnosis of LPR. Pepsin is the main factor in tissue damage in LPR and it can cause mucosal damage, even in non-acidic reflux episodes. So, pepsin can be a good alternative as a diagnostic method, specially in patients with non-acidic reflux. The detection of pepsin in saliva or sputum by immunoserology is a rapid, easy to perform and cost effective method. Objective: The aim of this work is to assess the value of Pepsin measurement in the sputum/saliva as a non-invasive method for diagnosing Laryngopharyngeal reflux (LPR). . Methods: The present study was performed on fifty subject; Group (I) twenty five patients had manifest LPR and Group (II) twenty five subject act as control group. Their classification and diagnosis based on upper GIT endoscopic findings, reflux symptoms index.

Results: In this study the sensitivity of salivary pepsin in LPR patients is (100%) and the specificity of salivary pepsin in LPR patients is (99.6%) CONCLUSION: Pepsin detection in the sputum/salivacan be used as a non-invasive and rapid method for diagnosing Laryngopharyngeal reflux with pepsinhigh sensitivity (100%) and high specificity (99.6%)

Key Words: Laryngopharyngeal reflux, reflux symptoms index, upper GIT endoscopy and salivary pepsin.