High Prevalence of Laryngopharyngeal Reflux Disease in Patients With Lumbar Kyphosis
Introduction
Symptoms of laryngopharyngeal reflux disease (LPRD) are considered extraesophageal symptoms of gastroesophageal reflux disease (GERD). However, patients with LPRD do not always have GERD.1 Hence, when clinicians investigate laryngopharyngeal (LPR) symptoms, it is important to specifically diagnose for LPRD. Previous studies have suggested that LPRD is associated with various diseases such as esophageal adenocarcinoma, subglottic stenosis, and diabetes.2, 3, 4 Thus, when physicians examine patients with esophageal cancer, subglottic stenosis, and diabetes, LPRD should also be evaluated.
Kyphosis is associated with GERD and esophageal hiatal hernia.5 Patients with this spinal disease have a global sagittal imbalance due to a forward rounding back. The majority of patients with kyphosis are elderly women. Kyphosis is a growing health concern in some developed countries, including Japan where the proportion of elderly individuals aged ≥65 years is the highest in the world.6
Although LPRD and lumbar kyphosis may be independently associated with GERD, no previous study has explored the relationship between LPRD and lumbar kyphosis directly. Therefore, the aims of this study were to explore the relationship between the presence of lumbar kyphosis and LPRD, and to investigate the LPR symptoms that may be related to lumbar kyphosis.
Section snippets
Subjects
The study participants were classified into a kyphosis group or a control group. All the participants visited the Department of Orthopedic Surgery at Sonoda Third Hospital between April 1, 2014 and January 31, 2015. Twenty patients with lumbar kyphosis were included in the kyphosis group, and 31 subjects who did not have lumbar kyphosis were included in the control group. The control group was almost matched with the kyphosis group for age and sex. None of the participants were taking a proton
Analysis 1
As demonstrated in Table 1, there was no significant difference in age, sex proportions, smoking habit, neurological disorder, and allergic rhinitis between the kyphosis group and the control group.
Analysis 2
The results of analysis 2 are shown in Table 2. Five of 20 (25%) patients in the kyphosis group and one of 31 (3.22%) subjects in the control group had symptoms consistent with LPRD. There was a significantly higher proportion of LPRD-positive patients in the kyphosis group than in the control group (
Discussion
This study has two important findings. First, there was a high prevalence of LPRD and GERD in the kyphosis groupcompared with than in the control group. Second, heartburn, hoarseness, and swallowing problems were symptoms statistically more common in the kyphosis group than in the control group.
Our study findings suggest that the prevalence of LPRD and GERD is significantly higher in patients with lumbar kyphosis. Some authors have reported a correlation between GERD and kyphosis.11, 12
Conclusions
Our study findings suggest that LPRD frequently coexists with lumbar kyphosis. Patients with kyphosis are more likely to have three LPR symptoms, such as heartburn, hoarseness, and a swallowing problem. To the best of our knowledge, this is the first study that demonstrates the association between lumbar kyphosis and LPRD. Otolaryngologists and orthopedic surgeons should be aware that patients with kyphosis are likely to have GERD and also LPRD.
Acknowledgments
The authors would like to thank Drs. Hiromi Matsuzaki and Keita Omori for helping with the data collection. We are particularly grateful to Prof. Seiichi Udagawa for providing valuable advice regarding the statistical analysis.
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Cited by (1)
Presented at the Combined Otolaryngology Spring Meetings, American Laryngological Association in Boston, Massachusetts from April 22 to 23, 2015.