možda mislite na laryngopharyngealni reflux, to je atipična forma gastroesophagealnog refluxa (GER), što podrazumeva vraćanje sadržaja želuca u gornje delove organa za varenje (u ezofagus, jednjak), zato što se donji ezofagealni sfinkter ne zatvara potpuno. to može da izazove smetnje, iritaciju sistema za disanje i varenje.
pročitajte, http://www.medicina.hr/clanci/gastroezo ... bolest.htm
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Laryngopharyngeal reflux (LPR), an atypical form of gastroesophageal reflux (GER), is defined as the backflow of gastric contents
into the esophagus, severe enough to reach the structures above the upper esophageal sphincter, without associated belching or vomiting. The
contact of gastric acid and pepsin, with the mucosa of the larynx, trachea, pharynx and oral cavity may cause non-specific symptoms of
upper aerodigestive system irritation and mucosal ulcerative lesions. Patients who see an otolaryngologist for their LFR-associated symptoms
and disorders, infrequently have the typical symptoms of GER, such as heartburn and regurgitation. A meticulous synthesis of the
information gathered from a detailed history, complete otolaryngologic examination focusing on the larynx, diagnostic laboratory tests that
detect and evaluate reflux, and response to treatment is essential for the diagnosis for LFR. Esophageal endoscopy and barium
esophagograms can be considered in patients with esophageal symptoms; otherwise, esophagitis is rare in patients with LFR-associated
otolaryngologic disorders and the role of these diagnostic methods are limited. 24-hour, double channel pH monitoring study of the
esophagus is the most sensitive and specific test for the diagnosis of LFR. Interpretation of the pH monitoring data should consider the
technical difficulties of the test and the different characteristics of reflux events in otolaryngologic patients. pH monitoring may not detect
reflux in all patients, due to the intermittant nature of laryngopharyngeal reflux. The presence of different reflux patterns and the lack of an
ideal diagnostic test, justifiy the use of improvement in the signs and symptoms with an empirical trial of treatment as a diagnostic tool.
Medical treatment of LFR consists of life-style modifications and acid supressive agents. Proton pump inhibitors provide a better success rate
in patients with LFR, compared to H2
blockers; the duration of the treatment should not be less than three months and the standart dos should
be doubled (i.e. lansoprazole 30 mgr BID, or omeprazole 20 mgr BID). Patients who do not respond to medications, develop frequent
relapses and have LFR-related complications of the upper respiratory system are candidates for the surgical treatment of reflux. Nissen
fundoplication, that can also be performed laparoscopically, is the most commonly used surgical procedure, with high success rates