The Experts below are selected from a list of 6336 Experts worldwide ranked by ideXlab platform
Reza Shaker - One of the best experts on this subject based on the ideXlab platform.
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Pharyngo‐UES contractile reflex in patients with posterior Laryngitis
Laryngoscope, 1998Co-Authors: Seckin O. Ulualp, Robert J. Toohill, Mark Kern, Reza ShakerAbstract:Background: Earlier studies have shown that stimulation of the human pharynx by injection of minute amounts of water stimulates the pharyngo-UES contractile reflex. It has been suggested that this reflex may be activated during pharyngeal reflux of gastric and/or esophageal content, thus increasing the UES pressure and possibly preventing further entry of the refluxate into the pharynx. However, the integrity of this reflex in patients with posterior Laryngitis has not been studied. Aim: Evaluate the pharyngo-UES contractile reflex in a group of patients with objective findings of posterior Laryngitis. Methods: Fourteen consecutive patients with posterior Laryngitis (mean age, 48 ± 6 y) and 13 healthy volunteers (mean age, 53 ± 6 y) were studied by concurrent pharyngeal water stimulation and UES manometry. Results: The threshold volume required to evoke the pharyngo-UES contractile reflex in the Laryngitis group (0.4 ± 0.05 mL) was significantly higher than that of the control (0.2 ± 0.04 mL) (P < .05). Following stimulation of the pharyngo-UES contractile reflex, the maximum postinjection pressure in patients (75 ± 6 mm Hg) was similar to that of the controls (78 ± 6 mm Hg). The percent increase in UES pressure following stimulation of the reflex in the Laryngitis group (99% ± 15%) was significantly higher than that of controls (55% ± 11%) (P < .05). Conclusions: Compared with normal controls, a significantly larger volume of liquid is required to trigger this reflex in patients with posterior Laryngitis. When triggered, the maximum UES pressure induced by the pharyngo-UES contractile reflex is similar between the two groups. These findings suggest an altered afferent sensory limb of this reflex in patients with posterior Laryngitis. Key Words: Upper esophageal sphincter, reflux Laryngitis, airway protection.
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pharyngo ues contractile reflex in patients with posterior Laryngitis
Laryngoscope, 1998Co-Authors: Seckin O. Ulualp, Robert J. Toohill, Mark Kern, Reza ShakerAbstract:Background: Earlier studies have shown that stimulation of the human pharynx by injection of minute amounts of water stimulates the pharyngo-UES contractile reflex. It has been suggested that this reflex may be activated during pharyngeal reflux of gastric and/or esophageal content, thus increasing the UES pressure and possibly preventing further entry of the refluxate into the pharynx. However, the integrity of this reflex in patients with posterior Laryngitis has not been studied. Aim: Evaluate the pharyngo-UES contractile reflex in a group of patients with objective findings of posterior Laryngitis. Methods: Fourteen consecutive patients with posterior Laryngitis (mean age, 48 ± 6 y) and 13 healthy volunteers (mean age, 53 ± 6 y) were studied by concurrent pharyngeal water stimulation and UES manometry. Results: The threshold volume required to evoke the pharyngo-UES contractile reflex in the Laryngitis group (0.4 ± 0.05 mL) was significantly higher than that of the control (0.2 ± 0.04 mL) (P < .05). Following stimulation of the pharyngo-UES contractile reflex, the maximum postinjection pressure in patients (75 ± 6 mm Hg) was similar to that of the controls (78 ± 6 mm Hg). The percent increase in UES pressure following stimulation of the reflex in the Laryngitis group (99% ± 15%) was significantly higher than that of controls (55% ± 11%) (P < .05). Conclusions: Compared with normal controls, a significantly larger volume of liquid is required to trigger this reflex in patients with posterior Laryngitis. When triggered, the maximum UES pressure induced by the pharyngo-UES contractile reflex is similar between the two groups. These findings suggest an altered afferent sensory limb of this reflex in patients with posterior Laryngitis. Key Words: Upper esophageal sphincter, reflux Laryngitis, airway protection.
M M Szczesniak - One of the best experts on this subject based on the ideXlab platform.
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upregulation of the esophago ues relaxation response a possible pathophysiological mechanism in suspected reflux Laryngitis
Neurogastroenterology and Motility, 2010Co-Authors: M M Szczesniak, Rohan B H Williams, H M Brake, Julia Maclean, I E Cole, Ian J CookAbstract:Background Inappropriate or excessive, non-swallow related, reflexive relaxation of the upper esophageal sphincter (UES) in response to esophageal distension may be the principal mechanism permitting retrograde trans-sphincteric flow during acid regurgitation. The neural pathways mediating reflexive UES relaxation in the human have received little attention. Patients with Laryngitis demonstrate an increased acid reflux in the proximal esophagus. Such events, combined with an increased tendency for UES relaxation, might precipitate regurgitation into the pharynx. The aim was to determine whether the esophago-UES relaxation reflex induced by rapid esophageal distension is upregulated in patients with posterior Laryngitis. Methods In 21 healthy volunteers and 14 patients with posterior Laryngitis, UES responses to rapid air insufflation were examined. UES responses were monitored with perfused manometry catheter with a oval sleeve sensor. Key Results The probability of triggering UES relaxation in response to the rapid esophageal air distension, for all volumes of insufflation, was higher in Laryngitis (45%) than in health (17%). The minimum distension volume required to elicit an UES relaxation response was significantly lower in Laryngitis patients when compared with controls. Patients who demonstrated a laryngoscopic response to a trial of omeprazole, were less likely to generate a distension-induced UES contractile response (5%) than patients who did not respond (23%). Conclusions & Inferences The threshold for esophageal distension-induced UES relaxation is reduced in patients with Laryngitis when compared with controls. This finding supports the hypothesis that in this population, a hypersensitive belch-like response may be one contributory mechanism of regurgitation when triggered by an abrupt spontaneous gastro-esophageal reflux event.
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predictors of outcome in an open label therapeutic trial of high dose omeprazole in Laryngitis
The American Journal of Gastroenterology, 2004Co-Authors: Rohan B H Williams, M M Szczesniak, H M Brake, Julia Maclean, I E Cole, Ian J CookAbstract:Predictors of Outcome in an Open Label, Therapeutic Trial of High-Dose Omeprazole in Laryngitis
Ian J Cook - One of the best experts on this subject based on the ideXlab platform.
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upregulation of the esophago ues relaxation response a possible pathophysiological mechanism in suspected reflux Laryngitis
Neurogastroenterology and Motility, 2010Co-Authors: M M Szczesniak, Rohan B H Williams, H M Brake, Julia Maclean, I E Cole, Ian J CookAbstract:Background Inappropriate or excessive, non-swallow related, reflexive relaxation of the upper esophageal sphincter (UES) in response to esophageal distension may be the principal mechanism permitting retrograde trans-sphincteric flow during acid regurgitation. The neural pathways mediating reflexive UES relaxation in the human have received little attention. Patients with Laryngitis demonstrate an increased acid reflux in the proximal esophagus. Such events, combined with an increased tendency for UES relaxation, might precipitate regurgitation into the pharynx. The aim was to determine whether the esophago-UES relaxation reflex induced by rapid esophageal distension is upregulated in patients with posterior Laryngitis. Methods In 21 healthy volunteers and 14 patients with posterior Laryngitis, UES responses to rapid air insufflation were examined. UES responses were monitored with perfused manometry catheter with a oval sleeve sensor. Key Results The probability of triggering UES relaxation in response to the rapid esophageal air distension, for all volumes of insufflation, was higher in Laryngitis (45%) than in health (17%). The minimum distension volume required to elicit an UES relaxation response was significantly lower in Laryngitis patients when compared with controls. Patients who demonstrated a laryngoscopic response to a trial of omeprazole, were less likely to generate a distension-induced UES contractile response (5%) than patients who did not respond (23%). Conclusions & Inferences The threshold for esophageal distension-induced UES relaxation is reduced in patients with Laryngitis when compared with controls. This finding supports the hypothesis that in this population, a hypersensitive belch-like response may be one contributory mechanism of regurgitation when triggered by an abrupt spontaneous gastro-esophageal reflux event.
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predictors of outcome in an open label therapeutic trial of high dose omeprazole in Laryngitis
The American Journal of Gastroenterology, 2004Co-Authors: Rohan B H Williams, M M Szczesniak, H M Brake, Julia Maclean, I E Cole, Ian J CookAbstract:Predictors of Outcome in an Open Label, Therapeutic Trial of High-Dose Omeprazole in Laryngitis
Seckin O. Ulualp - One of the best experts on this subject based on the ideXlab platform.
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Pharyngo‐UES contractile reflex in patients with posterior Laryngitis
Laryngoscope, 1998Co-Authors: Seckin O. Ulualp, Robert J. Toohill, Mark Kern, Reza ShakerAbstract:Background: Earlier studies have shown that stimulation of the human pharynx by injection of minute amounts of water stimulates the pharyngo-UES contractile reflex. It has been suggested that this reflex may be activated during pharyngeal reflux of gastric and/or esophageal content, thus increasing the UES pressure and possibly preventing further entry of the refluxate into the pharynx. However, the integrity of this reflex in patients with posterior Laryngitis has not been studied. Aim: Evaluate the pharyngo-UES contractile reflex in a group of patients with objective findings of posterior Laryngitis. Methods: Fourteen consecutive patients with posterior Laryngitis (mean age, 48 ± 6 y) and 13 healthy volunteers (mean age, 53 ± 6 y) were studied by concurrent pharyngeal water stimulation and UES manometry. Results: The threshold volume required to evoke the pharyngo-UES contractile reflex in the Laryngitis group (0.4 ± 0.05 mL) was significantly higher than that of the control (0.2 ± 0.04 mL) (P < .05). Following stimulation of the pharyngo-UES contractile reflex, the maximum postinjection pressure in patients (75 ± 6 mm Hg) was similar to that of the controls (78 ± 6 mm Hg). The percent increase in UES pressure following stimulation of the reflex in the Laryngitis group (99% ± 15%) was significantly higher than that of controls (55% ± 11%) (P < .05). Conclusions: Compared with normal controls, a significantly larger volume of liquid is required to trigger this reflex in patients with posterior Laryngitis. When triggered, the maximum UES pressure induced by the pharyngo-UES contractile reflex is similar between the two groups. These findings suggest an altered afferent sensory limb of this reflex in patients with posterior Laryngitis. Key Words: Upper esophageal sphincter, reflux Laryngitis, airway protection.
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pharyngo ues contractile reflex in patients with posterior Laryngitis
Laryngoscope, 1998Co-Authors: Seckin O. Ulualp, Robert J. Toohill, Mark Kern, Reza ShakerAbstract:Background: Earlier studies have shown that stimulation of the human pharynx by injection of minute amounts of water stimulates the pharyngo-UES contractile reflex. It has been suggested that this reflex may be activated during pharyngeal reflux of gastric and/or esophageal content, thus increasing the UES pressure and possibly preventing further entry of the refluxate into the pharynx. However, the integrity of this reflex in patients with posterior Laryngitis has not been studied. Aim: Evaluate the pharyngo-UES contractile reflex in a group of patients with objective findings of posterior Laryngitis. Methods: Fourteen consecutive patients with posterior Laryngitis (mean age, 48 ± 6 y) and 13 healthy volunteers (mean age, 53 ± 6 y) were studied by concurrent pharyngeal water stimulation and UES manometry. Results: The threshold volume required to evoke the pharyngo-UES contractile reflex in the Laryngitis group (0.4 ± 0.05 mL) was significantly higher than that of the control (0.2 ± 0.04 mL) (P < .05). Following stimulation of the pharyngo-UES contractile reflex, the maximum postinjection pressure in patients (75 ± 6 mm Hg) was similar to that of the controls (78 ± 6 mm Hg). The percent increase in UES pressure following stimulation of the reflex in the Laryngitis group (99% ± 15%) was significantly higher than that of controls (55% ± 11%) (P < .05). Conclusions: Compared with normal controls, a significantly larger volume of liquid is required to trigger this reflex in patients with posterior Laryngitis. When triggered, the maximum UES pressure induced by the pharyngo-UES contractile reflex is similar between the two groups. These findings suggest an altered afferent sensory limb of this reflex in patients with posterior Laryngitis. Key Words: Upper esophageal sphincter, reflux Laryngitis, airway protection.
Pieter J Noordzij - One of the best experts on this subject based on the ideXlab platform.
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proton pump inhibitor therapy for suspected gerd related chronic Laryngitis a meta analysis of randomized controlled trials
The American Journal of Gastroenterology, 2006Co-Authors: Mohammed A Qadeer, Pieter J Noordzij, Christopher O Phillips, Rocio A Lopez, David L Steward, Maria V Suurna, Thomas Havas, Colin W Howden, Michael F VaeziAbstract:Proton Pump Inhibitor Therapy for Suspected GERD-Related Chronic Laryngitis: A Meta-Analysis of Randomized Controlled Trials
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correlation of ph probe measured laryngopharyngeal reflux with symptoms and signs of reflux Laryngitis
Laryngoscope, 2002Co-Authors: Pieter J Noordzij, Aliaa Khidr, Ellen Desper, James F Reibel, Robert B Meek, Paul A LevineAbstract:Objectives/Hypothesis: Laryngitis secondary to gastric acid reflux is a prevalent, yet incompletely understood, otolaryngological disorder. Further characterization of the relationship between symptoms and signs and reflux severity is needed. Study Design: Prospective clinical trial. Methods: Forty-two consecutive, nonsmoking patients with one or more reflux Laryngitis symptoms were recruited to complete a symptom questionnaire, videostrobolaryngoscopy, and 24-hour, dual-sensor pH probe testing. Twenty-nine patients had more than four episodes of laryngopharyngeal reflux, and the remaining 13 served as control subjects. Symptom scores were produced by multiplying the severity by the frequency for the following: hoarseness, throat pain, lump-inthroat sensation, throat clearing, cough, excessive phlegm, dysphagia, odynophagia, and heartburn. Endoscopic laryngeal signs included erythema and edema of the vocal folds and arytenoids, and interarytenoid irregularity. Results: Symptom scores varied significantly, with throat clearing being greater than the rest. None of the symptoms, except heartburn, correlated with reflux (laryngopharyngeal and esophageal) severity. Patients with worse laryngopharyngeal reflux were found to have worse esophageal reflux. Endoscopic laryngeal signs were rated as mild, on average, and did not correlate with laryngopharyngeal reflux severity. The number of laryngopharyngeal reflux episodes (per 24 h) ranged from 0 to 40 (mean number, 10.6 episodes). Conclusions: Throat clearing was the most intense symptom in the present group of patients with proven reflux Laryngitis. Dual-sensor pH probe testing could not predict the severity of patient's reflux Laryngitis symptoms or signs. Only the heartburn symptom correlated with laryngopharyngeal and esophageal reflux.
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evaluation of omeprazole in the treatment of reflux Laryngitis a prospective placebo controlled randomized double blind study
Laryngoscope, 2001Co-Authors: Pieter J Noordzij, Aliaa Khidr, Brent A Evans, Ellen Desper, Ravinder K Mittal, James F Reibel, Paul A LevineAbstract:Objectives Proton-pump inhibitors are often recommended in the treatment of Laryngitis secondary to gastric reflux. Despite prospective treatment studies reporting high efficacy, only one previous report has been placebo-controlled and blinded. The objective of this study was to determine the efficacy of omeprazole in treating proven reflux Laryngitis. Study Design Prospective, placebo-controlled, randomized, double-blind clinical trial. Methods Fifty-three patients with one or more reflux Laryngitis symptoms were recruited to undergo 24-hour dual-channel pH probe testing. Thirty patients with more than four episodes of laryngopharyngeal reflux were enrolled. By random assignment, 15 patients received 40 mg omeprazole twice a day and the other 15 received placebo for a period of 2 months. Symptoms (hoarseness, throat pain, lump in throat sensation, throat clearing, cough, excessive phlegm, dysphagia, odynophagia, and heartburn) and endoscopic laryngeal signs (erythema, edema, and mucus accumulation) were recorded initially, at 1 month, and 2 months. Results In general, most symptom scores improved over time for both the omeprazole and placebo groups. Hoarseness, when patients begin with low hoarseness symptom scores, and throat clearing improved significantly more in patients on omeprazole than in those on placebo during the 2-month study. Throat pain, lump in throat sensation, excessive phlegm, difficulty swallowing, pain with swallowing, and heartburn showed improvement in both treatment arms, signifying the possibility of a placebo effect. Endoscopic laryngeal signs did not change significantly over the course of the study for either treatment group. Conclusions A placebo effect appears to exist in the treatment of reflux Laryngitis. However, hoarseness, when initially scored low, and throat clearing resulting from reflux Laryngitis are effectively treated by omeprazole.
