Abstracts
2000 Digestive Disease Week

# 2259 Pharyngeal pH Measurements in Patients with Laryngeal Symptoms Prior to and During Proton Pump Inhibitor Therapy.
Pablo E. Omelanczuk, Thomas R. Eubanks, Santiago Horgan, Nicole Maronian, Alan Hillel, Charles E. Pope, Carlos A. Pellegrini, Chicago, IL, Seattle, WA

Pharyngeal pH monitoring has been used to identify GERD as an etiology of laryngeal symptoms. We performed pharyngeal pH monitoring on patients with laryngeal symptoms prior to and during proton pump inhibitor therapy to determine the clinical and physiologic response to acid suppression. Methods: The frequency of 22 symptoms was recorded on a scale of 0-4 during the patient interview. A four channel pH monitor was performed with the most proximal channel placed 1.5 cm above the upper esophageal sphincter. Symptoms and pH monitoring (of the esophagus and of the pharynx) were assessed prior to and 3 months after the initiation of double dose proton pump inhibitor therapy. The Wilcoxon Signed ranks test was used to assess symptom scores and a paired t test was used to assess the pH monitoring results. Results: Eight patients (5 women, 3 men) were evaluated. The most common symptoms included chronic cough, hoarseness and throat clearing. All patients had at least one episode of pharyngeal reflux (PR) and all episodes or pharyngeal reflux occurred in the upright position. Average symptom scores and results of pH testing are shown in table 1. All but one patient had elimination of pharyngeal reflux episodes while on medical therapy however the DeMeester score remained abnormal in 3 of the 8 patients taking proton pump inhibitors. Conclusion: Treatment of GERD improved the most common clinical symptoms in patients suspected of having acid-induced laryngeal symptoms at three months. Distal esophageal acid exposure was reduced but not abolished, and pharyngeal reflux was still detectable in one patient while on proton pump inhibitors.