Skip to main content
SpringerLink
Log in

Laryngopharyngeal reflux disease with nocturnal gastric acid breakthrough while on proton pump inhibitor therapy

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology and Head & Neck Aims and scope Submit manuscript

Abstract

Laryngopharyngeal reflux disease (LPRD) with nocturnal recovery of gastric acid secretion (nocturnal acid breakthrough: NAB) with proton pump inhibitors (PPI) was first reported. A 79-year-old Japanese woman complained of globus pharyngeus and mild heartburn was examined with the use of tetra-probe 24-h pH monitoring. She had been treated for reflux esophagitis (GERD) for 12 months prior to her visit to our office. She took Lansoprazole (30 mg/day) before dinner every day. The tetra-probe 24-h pH monitoring revealed that the recovery of gastric acid secretion occurred 6.5 h after taking the dose of PPI. The intragastric pH dropped < 4 at about 23:00 and remained below that level for 4 h and 50 min. The 24-h pH-metry at each probe showed that the nocturnal recovery of gastric acid secretion with PPI (NAB on PPI) influenced gastroesophageal and laryngopharyngeal refluxes. The symptoms of the pharynx and esophagus disappeared after taking H2 receptor antagonist (H2RA) additionally before bedtime.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Adachi K, Katsube T, Kawamura A, Takashima T, Yuki M, Amano K, Ishihara S, Fukuda R, Watanabe M, Kinoshita Y (2000) CYP2C19 genotype status and intragastric pH during dosing with lansoplazole or rabeprazole. Aliment Pharmacol Ther 14:1259–1266

    Article  PubMed  CAS  Google Scholar 

  2. Adachi K, Komazawa Y, Fujishiro H, Mihara T, Ono M, Yuki M, Kawamura A, Rumi MAK, Amano Y, Kinoshita Y (2003) Nocturnal gastric acid breakthrough during the administration of rabeprazole and ranitidine in Helicobacter pylori-negative subjects: effects of different regimens. J Gastroenterol 38:830–835

    Article  PubMed  CAS  Google Scholar 

  3. Bough ID Jr, Sataloff RT, Castell DO, Hills JR, Gideon RM, Spiegel JR (1995) Gastroesophageal reflux laryngitis resistant to omeprazole therapy. J Voice 9:205–211

    Article  PubMed  Google Scholar 

  4. Fackler WK, Ours TM, Vaezi MF, Richter JE (2002) Long-term effect of H2RA therapy on nocturnal gastric acid breakthrough. Gastroenterology 122:625–632

    Article  PubMed  CAS  Google Scholar 

  5. Ishizaki T, Horai Y (1999) Review article. Cytochrome P450 and the metabolism of proton pump inhibitors-emphasis on rabeprazole. Aliment Pharmacol Ther 13(Suppl 3):27–36

    Article  PubMed  CAS  Google Scholar 

  6. Koufman J, Sataloff RT, Toohill R (1996) Laryngopharyngeal reflux. Consensus conference report. J Voice 10:215–216

    Article  PubMed  CAS  Google Scholar 

  7. Peghini PL, Katz PO, Bracy NA, Castell DO (1998) Nocturnal recovery of gastric acid secretion with twice-daily dosing of proton pump inhibitors. Am J Gastroenterol 93:763–767

    Article  PubMed  CAS  Google Scholar 

  8. Sato K (2004) Tetra-probe 24-hour pH monitoring for laryngopharyngeal reflux disease. J Jpn Bronchoesophagol Soc 55:9–15

    Google Scholar 

  9. Sato K, Nakashima T (2004) Laryngopharyngeal reflux disease resistant to antiacid therapy. J Jpn Broncho-Esophagol Soc 55:414–422

    Google Scholar 

  10. Shirai N, Furuta T, Moriyama Y, Okochi H, Kobayashi K, Takashima M, Xiao F, Kosuge K, Nakagawa K, Hanai H, Chiba K, Ohashi K, Ishizaki T (2001) Effects of CYP2C19 genotype differences in the metabolism of omeprazole and rabeprazole on intragastric pH. Aliment Pharmacol Ther 15:1929–1937

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Kurume University, School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan

    Kiminori Sato

Authors
  1. Kiminori Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kiminori Sato.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sato, K. Laryngopharyngeal reflux disease with nocturnal gastric acid breakthrough while on proton pump inhibitor therapy. Eur Arch Otorhinolaryngol 263, 1121–1126 (2006). https://doi.org/10.1007/s00405-006-0117-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-006-0117-8

Keywords

Search

Navigation