Symptoms And Treatment Of Laryngopharyngeal Reflux ( Lpr )

1772 WordsMay 1, 20178 Pages
Introduction Laryngopharyngeal reflux (LPR) disease is defined as the backward flow of stomach content up to the throat. It has a wide variety of symptoms in the paedi-atric population, and is usually associated with many otolaryngological problems such as laryngitis, pharyn-gitis, rhinosinusitis, eustachian tube dysfunction, recur- rent otitis media, and otitis media with effusion (OME).1–6 Tasker et al. demonstrated that pepsinogen and pepsin could be found in the middle-ear fluid of OME patients, indicating that LPR disease could be a significant aetiological factor in the development of OME.7 Helicobacter pylori, a Gram-negative, micro-aerophilic bacterium that can cause infection of the stomach, is likewise strongly linked to LPR…show more content…
The local ethics committee had approved the study. Procedure A pilot study was conducted, in which 10 children with OME, with positive H pylori stool antigen results, were subjected to ventilation tube insertion under general anaesthesia. Middle-ear fluid was aspirated with a micro-aspiration cannula (blood contamination was entirely avoided; effusion samples were collected under completely sterile conditions). Gastric lavage was performed with an orogastric Nelaton catheter. This was inserted into the stomach, and 10 cc of saline solution was injected and subsequently aspirated back into the injector. All ear and gastric lavage samples were processed within 4 hours of collection. They showed positive reactions for catalase, oxidase and urease. In addition, polymerase chain reaction ana-lysis revealed that all were positive for H pylori infection. For the main study, all stool samples of the 258 chil-dren diagnosed with bilateral OME were examined for H pylori using the H pylori stool antigen test.12 In total, 124 children were negative for H pylori stool antigen and received standard OME therapy of amoxicillin-clavulanate (90 mg/kg/day)13 for 4 weeks. A total of 134 children were positive for H pylori stool antigen. The H pylori positive children were equally and ran-domly allocated either to a control group or a study group, each with 67 children. The control group

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