Gambaran Kadar Pepsin pada Saliva Pasien Refluks Laringofaring di RSUP Dr. M. Djamil Padang

Authors

  • Mutiara Adinda Rahma Univesitas Andalas
  • Ade Asyari
  • Yustini Alioes

DOI:

https://doi.org/10.25077/jokli.v2i1.38

Keywords:

laringofaringeal reflux, pepsin, saliva

Abstract

Laryngopharyngeal reflux (RFL) is a condition of tissue inflammation in the upper aerodigestive tract due to the reflux of gastric and duodenal contents, the symptoms such as post-nasal drip, globus sensation, and heartburn which decrease quality of life. RFL was diagnosed subjectively using the Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). The pepsin levels in saliva that were detected by ELISA can be a sensitive and objective diagnostic marker for RFL because pepsin was only produced by chief cells in the stomach. The purpose of this study was to determine the characteristics of RFL patients based on age, sex, features of complaints in RSI, features of anatomic abnormalities in RFS, and salivary pepsin levels.

This study was a descriptive observational retrospective design. From September to October 2022, this study was carried out at the Medical Record Department of RSUP Dr. M. Djamil Padang. The Lemeshow formula was used as the minimum number sampling in this study, 22% was the value of the proportion of events. 

The findings of this study revealed that 20 patients with RFL were tested for pepsin levels in saliva at Dr. RSUP. M. Djamil Padang, with nearly the same total number of RFL patients in each age group. The majority of RFL patients (60.0%) were female, and the most common complaint felt by RFL sufferers was post-nasal drip (90.00%). The most common anatomic abnormality was diffuse laryngeal edema (100%), and the mean pepsin levels in saliva was 15.863 ng/mL. Pepsin was found in all samples.

Keywords: laringofaringeal reflux, pepsin, saliva

References

Lechien JR, Saussez S, Schindler A, Karkos PD, Hamdan AL, Harmegnies B, et al. Clinical outcomes of laryngopharyngeal reflux treatment: A systematic review and meta-analysis. Laryngoscope. 2019 May 1;129(5):1174–87.

Koufman, J A. The otolaryngologic manifistation of reflux disease. A clinical investigation of 225 patients hour pH monitoring and an experimental investigation pepsin in the development of laryngeal njury. Laryngoscope ?4. 1991;101:Pt 2.-Suppl 53.-P.1-78.

Vance D, Alnouri G, Shah P, O’Connell Ferster AP, Lyons K, Ross J, et al. The validity and reliability of the reflux finding score. Journal of Voice. 2020; S0892-1997(20)30421-5.

Almeida AG do P, Saliture TBS, da Silva ÁS, Eckley CA. Translation and cultural adaptation of the reflux finding score into Brazilian Portuguese. Braz J Otorhinolaryngol. 2013;79(1):47–53.

Silva ÁS, Duprat AC, Machado SR, Melo DN, Nascimento Ribeiro DK. Evaluation of the reflux symptom index and the endolaryngeal findings scale after treatment in individuals with laryngopharyngeal reflux. Int Arch Otorhinolaryngol. 2021 Jan;25(1): e115-e122.

Postma GN. Ambulatory pH monitoring methodology. Ann Otol Rhinol Laryngol Suppl. 2000; 184:10-4.

Bardhan KD, Strugala V, Dettmar PW. Reflux revisited: advancing the role of pepsin. Int J Otolaryngol. 2012 ;2012:1–13.

Birti? D, Vceva A, Kotromanovi? Z, Zubci? Z, Mihalj H, Jovanovi? S. Significance of the Pepsin from the Saliva in the Diagnosis and Treatment of Laryngopharyngeal Reflux Disease. Coll Antropol. 2012;36(2):83–6.

Knight J, Lively MO, Johnston N, Dettmar PW, Koufman JA. Sensitive pepsin immunoassay for detection of laryngopharyngeal reflux. Laryngoscope. 2005;115(8):1473–8.

Do?ru M, Kuran G, Hayto?lu S, Dengiz R, Ar?kan OK. Role of laryngopharyngeal reflux in the pathogenesis of otitis media with effusion. J Int Adv Otol. 2015;11(1):66–71.

Iannella G, di Nardo G, Plateroti R, Rossi P, Plateroti AM, Mariani P, et al. Investigation of pepsin in tears of children with laryngopharyngeal reflux disease. Int J Pediatr Otorhinolaryngol. 2015;79(12):2312–5.

Andriani Y, Akil MA, Gaffar M, Punagi AQ. Deteksi pepsin pada penderita refluks laringofaring yang didiagnosis berdasarkan reflux symptom index dan reflux finding score. Oto Rhino Laryngologica Indonesiana. 2011;41(2):121.

Guo Z, Wu H, Jiang J, Zhang C. Pepsin in saliva as a diagnostic marker for gastroesophageal reflux disease: A meta-analysis. Medical Science Monitor. 2018;24:9509–16.

Carrau RL, Khidr A, Crawley JA, Hillson EM, Davis JK, Pashos CL. The impact of laryngopharyngeal reflux on patient-reported quality of life. Laryngoscope. 2004;114(4):670–4.

Xiao S, Li J, Zheng H, Yan Y, Li X, Zhang L, et al. An epidemiological survey of laryngopharyngeal reflux disease at the otorhinolaryngology-head and neck surgery clinics in China. European Archives of Oto-Rhino-Laryngology. 2020 Oct 1;277(10):2829–38.

Asyari A, Amri D, Fitri F, Yerizal E, Bachtiar H, Zulka Kautzia Rachmawati E, et al. Deteksi pepsin pada saliva pasien refluks laringofaring. Oto Rhino Laryngologica Indonesiana. 2018;48(1):65–73.

Kahane JC. Connective tissue changes in the larynx and their effects on voice. Journal of Voice. 1987 Jan 1;1(1):27–30.

Johns MM, Arviso LC, Ramadan F. Challenges and opportunities in the management of the aging voice. Vol. 145, Otolaryngology - Head and Neck Surgery. 2011. p. 1–6.

Mesallam TA, Stemple JC, Sobeih TM, Elluru RG. Reflux symptom index versus reflux finding score. Ann Otol Rhinol Laryngol. 2007;116(6):436–40.

Andriani Y, Akil MA, Gaffar M, Punagi AQ. Deteksi pepsin pada penderita refluks laringofaring yang didiagnosis berdasarkan reflux symptom index dan reflux finding score. Oto Rhino Laryngologica Indonesiana. 2011;41(2):121.

Zhukhovitskaya A, Battaglia D, Khosla SM, Murry T, Sulica L. Gender and age in benign vocal fold lesions. Laryngoscope. 2015;125(1):191–6.

Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). J Voice. 2002;16(2):274–7.

Anggraini G, Kandhi PW. Karakteristik dan gaya hidup penderita dengan refluks laringofaring di RSUD Dr. Moewardi Surakarta. Jurnal Medika Moewardi. 2015;3-4.

Hanson DG, Jiang J, Chi W. Quantitative color analysis of laryngeal erythema in chronic posterior laryngitis. J Voice . 1998;12(1):78–83.

Iannella G, Vicini C, Polimeni A, Greco A, Gobbi R, Montevecchi F, et al. Laryngopharyngeal Reflux Diagnosis in Obstructive Sleep Apnea Patients Using the Pepsin Salivary Test. Int J Environ Res Public Health. 2019;16(11).

Toohill RJ, Kuhn JC. Role of Refluxed acid in pathogenesis of laryngeal disorders. Am J Med. 1997; 103(5A):100S-106S.

Divakaran S, Rajendran S, Thomas RM, Jacob J, Kurien M. Laryngopharyngeal Reflux: Symptoms, Signs, and Presence of Pepsin in Saliva - A Reliable Diagnostic Triad. Int Arch Otorhinolaryngol. 2021;25(2):e273.

Johnston N, Wells CW, Blumin JH, Toohill RJ, Merati AL. Receptor-mediated uptake of pepsin by laryngeal epithelial cells. Ann Otol Rhinol Laryngol. 2007 ;116(12):934–8.

Johnston N, Knight J, Dettmar PW, Lively MO, Koufman J. Pepsin and carbonic anhydrase isoenzyme III as diagnostic markers for laryngopharyngeal reflux disease. Laryngoscope. 2004;114(12):2129–34.

Zub?i? Ž, Mendeš T, V?eva A, Mihalj H, Bogovi? V, Milankovi? SG. Presence of pepsin in laryngeal tissue and saliva in benign and malignant neoplasms. Biosci Rep. 2020;40(11).

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Published

2023-12-26

How to Cite

Rahma, M. A. ., Asyari , A. ., & Alioes , Y. (2023). Gambaran Kadar Pepsin pada Saliva Pasien Refluks Laringofaring di RSUP Dr. M. Djamil Padang. Jurnal Otorinolaringologi Kepala Dan Leher Indonesia, 2(1). https://doi.org/10.25077/jokli.v2i1.38

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Penelitian