Some ORL’ Manifestations of Liver Biliary and Gastroesophageal Reflux Disease (GERD)
Mariana Penkova, Kiril Tenev, Pavel Dimov

Abstract
Introduction: Gastroesophageal reflux disease (GERD) includes all consequences of reflux acid or other irritants (pepsin, duodenal contents in liver biliary diseases) from the stomach into the esophagus. The main cause of gastroesophageal and duodenogastral reflux is incompetence of the antireflux barriers at the esophagogastric junction. Object: To determine the prevalence of ORL’ symptoms in patients with liver biliary and gastro-esophageal reflux disease (GERD). Material and Methods: The orodental and laryngopharyngeal status of 115 patients with upper gastrointestinal symptoms was examined. For all patients were made: standard ORL’examination; examinations of gastro-digestive tract: upper endoscopy, X- Ray of esophagus and stomach; abdominal ultrasonography, pH test. Patients with erosive esophagitis were classified according to the criteria of Los Angeles 2003. The results were evaluated in the SPSS program, version 10.0, and we carried out frequencies evaluation, central tendency and standard deviation measurements and association test (chi-square). Results: Patients with typical symptoms of gastroesophageal reflux accounted for 59 (51.3%), with atypical symptoms – 56 (48.7%). In 63 (54.8%) patients, the underlying pathosis was associated with increased acid output in the stomach (reflux esophagitis or duodenal ulcer), while in 52 (45.2%) patients who underwent cholecystectomy and other liver biliary diseases, the duodenogastric reflux was alkaline. Fifty one (80.9%) patients with ORL’symptoms were found of the group of 63 patients with reflux esophagitis or duodenal ulcer and 47 (90.4%) - of the group of 52 patients with duodenogastral reflux. Conclusion: Liver-Biliary and gastrointestinal diseases occurring with reflux of gastric or duodenal contents are a risk factor for orodental and laryngopharyngeal injury. The finding emphasizes the need for accurate diagnosis and appropriate treatment of patients with upper gastrointestinal symptoms in order to avoid irreversible ORL’symptoms.

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