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‘Persistent throat symptoms’ versus ‘laryngopharyngeal reflux’: a cross-sectional study refining the clinical condition
  1. James O'Hara1,2,
  2. Holly Fisher1,
  3. Louise Hayes1,
  4. Janet Wilson1
  1. 1Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
  2. 2Department of Otolaryngology - Head and Neck Surgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
  1. Correspondence to Dr James O'Hara; james.o'hara{at}newcastle.ac.uk

Abstract

Objective Many patients are assessed for chronic symptoms including: dysphonia, ‘globus’, throat clearing, postnasal secretions and cough; commonly grouped together and attributed to ‘laryngopharyngeal reflux’. This study aimed to explore a clinical trial’s baseline dataset for patterns of presenting symptoms, which might provide a more rational basis for treatment.

Design Baseline data were analysed for participants entering the Trial Of Proton-Pump Inhibitors in Throat Symptoms: age, body mass index, Reflux Symptom Index, Comprehensive Reflux Symptom Score, Laryngopharyngeal Reflux-Health-related Quality of Life questionnaire and Reflux Finding Score (RFS-endoscopic examination). The relationships between the questionnaires and demographic factors were assessed. Exploratory factor analysis (EFA) was conducted on individual symptom items in the combined questionnaires. The EFA factors were applied to a Cluster Analysis of participants, to explore the presence of identifiable patient.

Results Throat clearing and globus were the highest ranked scores in the 344 participants. Increasing age was inversely associated with symptom severity (p<0.01). There was no relationship between the RFS and any of the three questionnaires. EFA resulted in a seven-factor model with clinically meaningful labels: voice, cough, gastrointestinal symptoms, airway symptoms and dysphagia, throat clearing, lump in throat, and life events. Cluster analysis failed to demonstrate any clinically meaningful clusters of patients.

Conclusion This study offers a framework for future research and demonstrates that individual symptoms cannot be used to group patients. The analysis supports the use of a broad ‘umbrella’ term such as persistent throat symptoms.

Trial registration number ISRCTN38578686.

  • FUNCTIONAL BOWEL DISORDER
  • PROTON PUMP INHIBITION
  • DIAGNOSTIC AND THERAPEUTIC ENDOSCOPY

Data availability statement

No data are available. All data relevant to the study are included in the article or uploaded as online supplemental information.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Data availability statement

No data are available. All data relevant to the study are included in the article or uploaded as online supplemental information.

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Footnotes

  • Contributors JO’H is responsible for the overall content as guarantor. JO’H accepts full responsibility for the finished work and the conduct of the study, had access to the data, and controlled the decision to publish. JO’H and JW collected the data. JO’H, LH, HF and JW all contributed to the analysis of the data, interpretation of results and manuscript writing.

  • Funding This study received no financial support and was independent to the Trial Of Proton-Pump Inhibitors in Throat Symptoms, funded by the National Institute for Health Research in the UK.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.