Does laryngopharyngeal reflux cause intraoral burning sensations? A preliminary study
Department of Otorhinolaryngology-Head and Neck Surgery, Ludwig Maximilians University, Munich, Germany. Archives of Oto-Rhino-Laryngology
(Impact Factor: 1.55).
02/2011; 268(9):1375-81. DOI: 10.1007/s00405-011-1543-9
Intraoral burning sensations are a common problem in the otolaryngological practice. The aim of this study was to evaluate if laryngopharyngeal reflux can cause intraoral burning sensations by measuring oropharyngeal acid reflux. Patients with recurring intraoral burning sensations underwent oropharyngeal pH monitoring in our outpatient clinic. The pH catheter was placed at the level of the uvula. The catheter contained an externally worn transmitter, which wirelessly sent the data to a monitor. In addition, patients were instructed to indicate meals or the occurrence of burning sensations by pressing provided buttons on the monitor. Corresponding events of burning sensations and a significant decrease in oropharyngeal pH values should be visualized. Twenty two patients suffering from recurring intraoral burning sensations underwent oropharyngeal pH measurement for 21-25 h. We could find oropharyngeal reflux episodes in 11 patients. However, we could not detect any episodes of burning sensations in the mouth corresponding with a decrease in oropharyngeal pH values. Our results suggest that there is no causal connection between LPR episodes and the occurrence of intraoral burning sensations in the examined patients. Although further studies with more patients are necessary in the future, we conclude from our findings that recurring intraoral burning sensations are not an indication for proton pump inhibitor therapy.
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ABSTRACT: Burning mouth syndrome is a debilitating medical condition affecting nearly 1.3 million of Americans. Its common features include a burning painful sensation in the mouth, often associated with dysgeusia and xerostomia, despite normal salivation. Classically, symptoms are better in the morning, worsen during the day and typically subside at night. Its etiology is largely multifactorial, and associated medical conditions may include gastrointestinal, urogenital, psychiatric, neurologic and metabolic disorders, as well as drug reactions. BMS has clear predisposition to peri-/post menopausal females. Its pathophysiology has not been fully elucidated and involves peripheral and central neuropathic pathways. Clinical diagnosis relies on careful history taking, physical examination and laboratory analysis. Treatment is often tedious and is aimed at correction of underlying medical conditions, supportive therapy, and behavioral feedback. Drug therapy with alpha lipoic acid, clonazepam, capsaicin, and antidepressants may provide symptom relief. Psychotherapy may be helpful. Short term follow up data is promising, however, long term prognosis with treatment is lacking. BMS remains an important medical condition which often places a recognizable burden on the patient and health care system and requires appropriate recognition and treatment.
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ABSTRACT: Purpose of review:
The importance of laryngopharyngeal reflux (LPR) is acknowledged widely. However, controversy remains regarding pathophysiology, diagnosis, and treatment. This review addresses current literature from late 2009 through the first half of 2012 and complements our previous review of literature from 2006 through the middle of 2009. Both reviews highlight controversies and current research.
Although controversies have not been resolved fully, additional research has expanded approaches to diagnosis and treatment of LPR. Recent studies shed additional light on pathophysiology. New imaging techniques have been introduced and they prove particularly useful in assessing LPR. Research has improved the understanding of the value of selected acid measurement techniques. The efficacy of treatment remains controversial.
LPR clearly is an important entity. However, disagreements persist regarding optimal diagnosis techniques, criteria of normalcy, and treatment efficacy. Additional studies are encouraged to further our understanding of pathophysiology, diagnosis, treatment, and the long-term effects of LPR and LPR treatment.
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ABSTRACT: Burning mouth syndrome (BMS) is a chronic multifactorial painful condition which primarily affects peril/postmenopausal women. In the published literature there are conflicting data whether local and systemic factors as well as medication intake might contribute to the BMS. The aim of this study was to retrospectively obtain data from the patient charts of 328 BMS patients (270 females and 58 males), median age of the participants was 64 years (age range 17- 88 years)regarding local and systemic disturbances, medication intake and treatment response on the alleviation of oral symptoms. Statistical analysis was performed by use of Chi-square test to assess the differences between categorical variables while Mann Whitney test was used to assess the differences between continuous variables. P values lower than 0.05 were considered significant. Median duration of symptoms was significantly higher in females when compared to males (6 (range 1-180) versus2 (range 1-54); p=0.05). No significant differences in age, chief complaint, site, co morbidities, medication intake, and salivary flow rate and treatment outcome between males and females were found. Follow up data were available for 187 patients. One hundred seventeen patients (62.6%) reported their condition to be unchanged while 70 (37.4%) patients reported improvement compared to the baseline. None of the patients reported complete resolution of the symptoms. It may be concluded that there are no associations between burning mouth syndrome with investigated local and systemic diseases and drug intake as well as tried treatment options such as salivary substitutes, low level laser therapy, chlorhexetidine mouthwash and vitamin B1, B6 and B12 replacement therapy.
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