• 대한기관식도과학회지
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• 제3권1호
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• pp.79-83
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• 1997

The term laryngopharyngeal reflux (LPR) refers to the backflow of food or stomach acid back up into the larynx (the voice box) or the pharynx (the throat). Esophagopharyngeal reflux is suggested as an etiologic factor in laryngeal disease. To examine a possible esophageal basis for laryngopharyngeal symptoms, we studied 48 patients with persistent laryngopharyngeal symptoms, and 12 relative control subjects. Patients were evaluated for cervical symptoms by questionnaire and underwent gastrofiberoscopy, fiberoptic laryngoscopy, esophageal manometry and 24-hour ambulatory double-probe pH monitoring. We found LPR in fourteen out of 48 patients with cervical symptoms (29%). The LPR group consisted of nine men and five women. The symptoms that LPR patients complained were throat lump sensation, hoareness, sore throat, throat clearing, chronic coughing and dysphagia in order of frequency, and they were not different significantly from non-LPR patients. The laryngoscopic findings in LPR patients were posterior erythema, laryngeal edema and diffuse erythema, and there was also no significant difference between LPR group and non-LPR group. There was statistically significant correlation between LPR and gastroesophageal reflux (GER). We concluded that there is no pathognomonic symptoms or laryngoscopic findings in diagnosis of LPR, and 24-hour ambulatory double-probe pH monitoring is an essential diagnostic tool in LPR.

• 대한후두음성언어의학회지
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• 제19권2호
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• pp.136-141
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• 2008

Background and Objectives: Laryngopharyngeal reflux (LPR) is a very common disease among outpatients of department of otorhinolaryngology. Although there are several diagnostic tools for LPR disease and ambulatory 24-hour double-probe pH monitoring is gold standard method, empirical diagnosis by reflux symptom index and reflux finding score (RFS) are mainly used. So we analyzed the relationship between ambulatory 24-hour double-probe pH monitoring and RFS in patients with LPR. Subjective and Method: Fifty patients with LPR symptoms and abnormal RFS and ambulatory 24-hour double probe monitoring were enrolled. Each items and sum of laryngeal reflux score were compared the results of ambulatory 24-hour double-probe pH monitoring in upper (UES) and lower (LES) esophageal sphincter. Results: There were no significant correlation between the results of ambulatory 24-hour double-probe pH monitoring in UES (pH<4 and pH<5) and each item and sum of RFS. However, supine time and reflux number of UES (pH<5) were showed the partial correlations with diffuse laryngeal edema and thick endolaryngeal mucus (p=0.03, p=0.01). Although there were no relationship between the results of ambulatory 24-hour double-probe pH monitoring in LES and sum of RFS, the significant correlations presented between granuloma and total time (p=0.008), upright time (p=0.008, reflux number (p=0.049) of LES. Conclusion: Although granuloma among items of RFS showed significantly correlation with the results of ambulatory 24-hour double-probe pH monitoring in LES, there were no significant correlation between the results of ambulatory 24-hour double-probe pH monitoring in UES and LES and items and sum of RFS.

• Journal of Gastric Cancer
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• 제24권2호
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• pp.137-144
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• 2024

Purpose: Laparoscopic proximal gastrectomy (LPG) is a viable choice for treating proximal gastric lesions. However, the occurrence of severe reflux has limited its widespread adoption. To address this issue, the double flap technique (DFT), which incorporates artificial lower esophageal sphincteroplasty, has been developed to prevent reflux problems after proximal gastrectomy. In this study, we aimed to investigate the usefulness of this technique using high-resolution manometry (HRM), impedance pH monitoring, and esophagogastroduodenoscopy (EGD). Materials and Methods: The findings of pre- and postoperative 6-month HRM, pH monitoring, and EGD were compared for 9 patients who underwent LPG with DFT for various proximal gastric lesions at Incheon St. Mary's Hospital from January 2021 to December. Results: A total of 9 patients underwent proximal gastrectomy. Approximately half of the patients had Hill's grade under II preoperatively, whereas all patients had Hill's grades I and II in EGD findings. In the HRM test, there was no significant difference between distal contractile integral (1,412.46±1,168.51 vs. 852.66±495.62 mmHg·cm·s, P=0.087) and integrated relaxation pressure (12.54±8.97 vs. 8.33±11.30 mmHg, P=0.27). The average lower esophageal sphincter (LES) pressure was 29.19±14.51 mmHg preoperatively, which did not differ from 19.97±18.03 mmHg after the surgery (P=0.17). DeMeester score (7.02±6.36 vs. 21.92±36.17, P=0.21) and total acid exposure time (1.49±1.48 vs. 5.61±10.17, P=0.24) were slightly higher, but the differences were not statistically significant. Conclusions: There is no significant functional difference in HRM and impedance pH monitoring tests after DFT. DFT appears to be useful in preserving LES function following proximal gastrectomy.

• Journal of Gastric Cancer
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• 제4권4호
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• pp.225-229
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• 2004

목적: 위암 환자의 위절제술 후 발생하는 가슴 쓰림, 역류, 비심인성흉통 등 식도증상의 원인규명을 위해 위절제술 후 식도 산도 변화와 운동장애를 알 수 있는 24시간 보행성 식도 산도 검사(일부 환자에서 식도 내압 검사를 병행)를 실시하였다. 대상 및 방법: 2002년 7월부터 2004년 3월까지 위암으로 Billroth I을 시행한 환자와 위전절제술을 시행한 환자 중 무작위로 선택한 15예를 대상으로 술 후 음식 섭취 후 퇴원 전에 24시간 보행성 식도 산도 검사를 시행하였다. 산 역류의 양성 판정은 DeMeester 점수를 사용하여 점수 14.72 이상을 양성으로 하였고, 증상지수는 증상을 보인횟수 중 실제로 산도(pH)가 4 이하였던 경우를 나타내는 것으로 양성판정은 증상지수 $50\%$ 이상인 경우로 하였다. 결과: 무작위로 선택되어 검사한 15예 중 산역류양성 (DeMeester 14.72 이상)을 보인 예는 총 3예($20\%$)로 분석 되었다. 그 중 술 식에 따른 분포는 Billroth I경우는 총 12예 중 3예($25\%$)에서 양성반응을 보였고 위전절제술을 시행한 환자는 3예 중 양성반응을 보인 예가 없었다. 병기에 따른 분포는 각각 I (2예/9예), II (1예/2예), III (0예/3예), IV(0예/1예)였다. 10예에서 식도 내압 검사를 병행하였는데 그 중 7예에서 비특이적 식도운동장애로 분석되었다. 결론: 위암 환자의 위절제술 후 산 역류로 인한 위식도 역류질환이 발생했다. 위암수술로 Billroth I 재건술 후 생기는 위식도역류 증상은 담즙역류뿐만 아니라 위산 역류에 의해서도 생긴다.

• 대한불안의학회지
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• 제2권1호
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• pp.28-32
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• 2006

Objectives : Non-cardiac chest pain (NCCP) can be divided into gastroesophageal reflux disease (GERD) related NCCP and non-GERD related NCCP. Our study was designed to examine the differences in clinical characteristics and psychological mood states between the two clinical syndromes. Methods : After some cardiologic evaluations such as treadmill exercise, coronary angiography, and echocardiography, 27 patients with NCCP were enrolled in this study. They were divided into patients with GERD related NCCP (12 patients) and those with non-GERD related NCCP (15 patients) using the upper gastrointestinal endoscopy and the ambulatory 24 hour esophageal pH monitoring. Clinical characteristics such as typical reflux symptoms and psychological mood states were measured. Patients who showed scores more than 10 on the Beck Depression Inventory (BDI) or Beck Anxiety Inventory (BAI) were defined as depressed or anxious group. Anxiety sensitivity Index (ASI) was also measured in all patients. All parameters were compared between patients with GERD related NCCP and those with non-GERD related NCCP. Results : The two groups showed a difference in typical reflux symptoms. Patients with non-GERD related NCCP had higher scores on the BDI, BAI and ASI than those with GERD related NCCP. Among all NCCP patients, 14 patients (51.9%) were suggested to have possible depression or anxiety disorders. Conclusion : The non-GERD related NCCP was shown to be associated with psychological mood states such as anxiety and depression. Thus, we suggest that routine measurement of psychological mood states should be necessary in the evaluation and treatment of NCCP.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권1호
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• pp.92-98
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• 2001

덤핑증후군은 소아에서 위식도역류의 치료로 위저추벽성형술을 시행하는 경우에 잘 발생하는 질환으로 당 부하 검사를 통하여 식사 직후에 나타나는 고혈당과 뒤이어 나타나는 저혈당을 보임으로써 진단될 수 있으며, 생 옥수수 전분을 포함한 식이 요법으로 효과적으로 치료될 수 있다. 저자들은 위저추벽성형술을 시행 받은 뒤에 덤핑증후군이 발생한 1례를 경험하였고, 본 질환이 소아에서 위저추벽성형술과 같은 위 수술 후에 수유장애가 있을 경우 반드시 의심해보아야 할 질환이라고 사료되어 문헌 고찰과 함께 보고하는 바이다.