Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 11/2010

01-11-2010 | Miscellaneous

Heterotopic gastric mucosal patch of the esophagus is associated with higher prevalence of laryngopharyngeal reflux symptoms

Authors: Vui Heng Chong, Anand Jalihal

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2010

Login to get access

Abstract

Laryngopharyngeal reflux (LPR) is common in clinical practice. Heterotopic gastric mucosal patch of the proximal esophagus (HGMP) is reported to cause LPR symptoms. This study assessed the prevalence of LPR symptoms and correlation with the size of HGMP. Four hundred and sixty-two patients undergoing endoscopy were carefully questioned regarding LPR symptoms experienced in the previous 12 weeks. The size of the HGMP was assessed and documented during endoscopy. Clinicopathological classifications were assigned (types I–V) accordingly. HGMP [median one patch (range 1–3), median size 15 mm [335] was detected in 26 (19 HGM type I and 7 HGM type II] patients giving a prevalence of 5.6%. Among the indications, there were significantly more LPR symptoms as referral indications among patients with HGMP. There were no significant differences in the endoscopic findings. On specific enquiries, significantly more HGMP patients had experienced any LPR symptoms (73.1 vs. 25.9%, p < 0.001) specifically chronic cough (p = 0.002), throat discomfort/hoarseness (p < 0.001), globus sensation (p = 0.004), regurgitation (p < 0.001). HGMP patients also had more heartburn (p = 0.001). Larger HGMP (≥15 mm) was only associated with more chronic cough (p = 0.022). In conclusion, patients with HGMP have significantly more LPR symptoms. However, most were mild and detected through specific enquiries. Interestingly, the size of HGMP did not significantly affect the prevalence of LPR symptoms.
Literature
1.
go back to reference Akbayir N, Alkim C, Erdem L, Sökmen HM, Sungun A, Başak T, Turgut S, Mungan Z (2004) Heterotopic gastric mucosa in the cervical esophagus (inlet patch): endoscopic prevalence, histological and clinical characteristics. J Gastroenterol Hepatol 19:891–896CrossRefPubMed Akbayir N, Alkim C, Erdem L, Sökmen HM, Sungun A, Başak T, Turgut S, Mungan Z (2004) Heterotopic gastric mucosa in the cervical esophagus (inlet patch): endoscopic prevalence, histological and clinical characteristics. J Gastroenterol Hepatol 19:891–896CrossRefPubMed
2.
go back to reference Alaani A, Jassar P, Warfield AT, Gouldesbrough DR, Smith I (2007) Heterotopic gastric mucosa in the cervical oesophagus (inlet patch) and globus pharyngeus—an under-recognised association. J Laryngol Otol 121:885–888CrossRefPubMed Alaani A, Jassar P, Warfield AT, Gouldesbrough DR, Smith I (2007) Heterotopic gastric mucosa in the cervical oesophagus (inlet patch) and globus pharyngeus—an under-recognised association. J Laryngol Otol 121:885–888CrossRefPubMed
3.
go back to reference Avidan B, Sonnenberg A, Chejfec G, Schnell TG, Sontag SJ (2001) Is there a link between cervical inlet patch and Barrett’s esophagus? Gastrointest Endosc 53:717–721CrossRefPubMed Avidan B, Sonnenberg A, Chejfec G, Schnell TG, Sontag SJ (2001) Is there a link between cervical inlet patch and Barrett’s esophagus? Gastrointest Endosc 53:717–721CrossRefPubMed
4.
go back to reference Azar C, Jamali F, Tamim H, Abdul-Baki H, Soweid A (2007) Prevalence of endoscopically identified heterotopic gastric mucosa in the proximal esophagus: endoscopist dependent? J Clin Gastroenterol 41:468–471CrossRefPubMed Azar C, Jamali F, Tamim H, Abdul-Baki H, Soweid A (2007) Prevalence of endoscopically identified heterotopic gastric mucosa in the proximal esophagus: endoscopist dependent? J Clin Gastroenterol 41:468–471CrossRefPubMed
5.
go back to reference Bajbouj M, Becker V, Eckel F, Miehlke S, Pech O, Prinz C, Schmid RM, Meining A (2009) Argon plasma coagulation of cervical heterotopic gastric mucosa as an alternative treatment for globus sensations. Gastroenterology 137:440–444CrossRefPubMed Bajbouj M, Becker V, Eckel F, Miehlke S, Pech O, Prinz C, Schmid RM, Meining A (2009) Argon plasma coagulation of cervical heterotopic gastric mucosa as an alternative treatment for globus sensations. Gastroenterology 137:440–444CrossRefPubMed
6.
go back to reference Bataller R, Bordas JM, Ordi J, Llach J, Elizalde JI, Mondelo F (1995) Upper gastrointestinal bleeding: a complication of “inlet patch mucosa” in the upper esophagus. Endoscopy 27:282CrossRefPubMed Bataller R, Bordas JM, Ordi J, Llach J, Elizalde JI, Mondelo F (1995) Upper gastrointestinal bleeding: a complication of “inlet patch mucosa” in the upper esophagus. Endoscopy 27:282CrossRefPubMed
7.
go back to reference Chong VH, Jalihal A (2006) Cervical inlet patch: case series and literature review. South Med J 99:865–869CrossRefPubMed Chong VH, Jalihal A (2006) Cervical inlet patch: case series and literature review. South Med J 99:865–869CrossRefPubMed
8.
go back to reference Copper MP, Smit CF, Stanojcic LD, Devriese PP, Schouwenburg PF, Mathus-Vliegen LM (2000) High incidence of laryngopharyngeal reflux in patients with head and neck cancer. Laryngoscope 110:1007–1011CrossRefPubMed Copper MP, Smit CF, Stanojcic LD, Devriese PP, Schouwenburg PF, Mathus-Vliegen LM (2000) High incidence of laryngopharyngeal reflux in patients with head and neck cancer. Laryngoscope 110:1007–1011CrossRefPubMed
9.
go back to reference Cuddihy PJ, Maheshwar A, Griffith H (1998) Symptomatic heterotopic gastric mucosa in the upper oesophagus. J Laryngol Otol 112:979–981PubMed Cuddihy PJ, Maheshwar A, Griffith H (1998) Symptomatic heterotopic gastric mucosa in the upper oesophagus. J Laryngol Otol 112:979–981PubMed
10.
go back to reference Eryuksel E, Dogan M, Golabi P, Sehitoglu MA, Celikel T (2006) Treatment of laryngopharyngeal reflux improves asthma symptoms in asthmatics. J Asthma 43:539–542CrossRefPubMed Eryuksel E, Dogan M, Golabi P, Sehitoglu MA, Celikel T (2006) Treatment of laryngopharyngeal reflux improves asthma symptoms in asthmatics. J Asthma 43:539–542CrossRefPubMed
11.
go back to reference Eryuksel E, Dogan M, Olgun S, Kocak I, Celikel T (2009) Incidence and treatment results of laryngopharyngeal reflux in chronic obstructive pulmonary disease. Eur Arch Otorhinolaryngol 266:1267–1271CrossRefPubMed Eryuksel E, Dogan M, Olgun S, Kocak I, Celikel T (2009) Incidence and treatment results of laryngopharyngeal reflux in chronic obstructive pulmonary disease. Eur Arch Otorhinolaryngol 266:1267–1271CrossRefPubMed
12.
13.
go back to reference Galan AR, Katzka DA, Castell DO (1998) Acid secretion from an esophageal inlet patch demonstrated by ambulatory pH monitoring. Gastroenterology 115:1574–1576CrossRefPubMed Galan AR, Katzka DA, Castell DO (1998) Acid secretion from an esophageal inlet patch demonstrated by ambulatory pH monitoring. Gastroenterology 115:1574–1576CrossRefPubMed
14.
go back to reference Gutierrez O, Akamatsu T, Cardona H, Graham DY, El-Zimaity HM (2003) Helicobacter pylori and heterotopic gastric mucosa in the upper esophagus (the inlet patch). Am J Gastroenterol 98:1266–1270CrossRefPubMed Gutierrez O, Akamatsu T, Cardona H, Graham DY, El-Zimaity HM (2003) Helicobacter pylori and heterotopic gastric mucosa in the upper esophagus (the inlet patch). Am J Gastroenterol 98:1266–1270CrossRefPubMed
15.
go back to reference Hicks DM, Ours TM, Abelson TI, Vaezi MF, Richter JE (2002) The prevalence of hypopharynx findings associated with gastroesophageal reflux in normal volunteers. J Voice 16:564–579CrossRefPubMed Hicks DM, Ours TM, Abelson TI, Vaezi MF, Richter JE (2002) The prevalence of hypopharynx findings associated with gastroesophageal reflux in normal volunteers. J Voice 16:564–579CrossRefPubMed
16.
go back to reference Ishoo E, Busaba NY (2002) Ectopic gastric mucosa in the cervical esophagus. Am J Otolaryngol 23:181–184CrossRefPubMed Ishoo E, Busaba NY (2002) Ectopic gastric mucosa in the cervical esophagus. Am J Otolaryngol 23:181–184CrossRefPubMed
17.
go back to reference Jacobs E, Dehou MF (1997) Heterotopic gastric mucosa in the upper esophagus: a prospective study of 33 cases and review of literature. Endoscopy 29:710–715CrossRefPubMed Jacobs E, Dehou MF (1997) Heterotopic gastric mucosa in the upper esophagus: a prospective study of 33 cases and review of literature. Endoscopy 29:710–715CrossRefPubMed
18.
go back to reference Koufman JA (1991) The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 101:1–78CrossRefPubMed Koufman JA (1991) The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 101:1–78CrossRefPubMed
19.
go back to reference Koufman JA (2002) Laryngopharyngeal reflux is different from classic gastroesophageal reflux disease. Ear Nose Throat J 81:7–9PubMed Koufman JA (2002) Laryngopharyngeal reflux is different from classic gastroesophageal reflux disease. Ear Nose Throat J 81:7–9PubMed
20.
go back to reference Lancaster JL, Gosh S, Sethi R, Tripathi S (2006) Can heterotopic gastric mucosa present as globus pharyngeus? J Laryngol Otol 120:575–578CrossRefPubMed Lancaster JL, Gosh S, Sethi R, Tripathi S (2006) Can heterotopic gastric mucosa present as globus pharyngeus? J Laryngol Otol 120:575–578CrossRefPubMed
21.
go back to reference Lauwers GY, Scott GV, Vauthey JN (1998) Adenocarcinoma of the upper esophagus arising in cervical ectopic gastric mucosa: rare evidence of malignant potential of so-called “inlet patch”. Dig Dis Sci 43:901–907CrossRefPubMed Lauwers GY, Scott GV, Vauthey JN (1998) Adenocarcinoma of the upper esophagus arising in cervical ectopic gastric mucosa: rare evidence of malignant potential of so-called “inlet patch”. Dig Dis Sci 43:901–907CrossRefPubMed
22.
go back to reference Lauwers GY, Mino M, Ban S, Forcione D, Eatherton DE, Shimizu M, Sevestre H (2005) Cytokeratins 7 and 20 and mucin core protein expression in esophageal cervical inlet patch. Am J Surg Pathol 29:437–442CrossRefPubMed Lauwers GY, Mino M, Ban S, Forcione D, Eatherton DE, Shimizu M, Sevestre H (2005) Cytokeratins 7 and 20 and mucin core protein expression in esophageal cervical inlet patch. Am J Surg Pathol 29:437–442CrossRefPubMed
23.
go back to reference Macha S, Reddy S, Rabah R, Thomas R, Tolia V (2005) Inlet patch: heterotopic gastric mucosa–another contributor to supraesophageal symptoms? J Pediatr 147:379–382CrossRefPubMed Macha S, Reddy S, Rabah R, Thomas R, Tolia V (2005) Inlet patch: heterotopic gastric mucosa–another contributor to supraesophageal symptoms? J Pediatr 147:379–382CrossRefPubMed
24.
go back to reference Maconi G, Pace F, Vago L, Carsana L, Bargiggia S, Bianchi Porro G (2000) Prevalence and clinical features of heterotopic gastric mucosa in the upper oesophagus (inlet patch). Eur J Gastroenterol Hepatol 12:745–749CrossRefPubMed Maconi G, Pace F, Vago L, Carsana L, Bargiggia S, Bianchi Porro G (2000) Prevalence and clinical features of heterotopic gastric mucosa in the upper oesophagus (inlet patch). Eur J Gastroenterol Hepatol 12:745–749CrossRefPubMed
25.
go back to reference Mahieu HF (2007) Review article: The laryngological manifestations of reflux disease; why the scepticism? Aliment Pharmacol Ther 26(Suppl 2):17–24CrossRefPubMed Mahieu HF (2007) Review article: The laryngological manifestations of reflux disease; why the scepticism? Aliment Pharmacol Ther 26(Suppl 2):17–24CrossRefPubMed
26.
27.
go back to reference Poyrazoglu OK, Bahcecioglu IH, Dagli AF, Ataseven H, Celebi S, Yalniz M (2009) Heterotopic gastric mucosa (inlet patch): endoscopic prevalence, histopathological, demographical and clinical characteristics. Int J Clin Pract 63:287–291CrossRefPubMed Poyrazoglu OK, Bahcecioglu IH, Dagli AF, Ataseven H, Celebi S, Yalniz M (2009) Heterotopic gastric mucosa (inlet patch): endoscopic prevalence, histopathological, demographical and clinical characteristics. Int J Clin Pract 63:287–291CrossRefPubMed
28.
go back to reference Righini CA, Faure C, Karkas A, Schmerber S, Reyt E (2007) Spontaneous perforation in the upper oesophagus resulting from ulcer in heterotopic gastric mucosa. Rev Laryngol Otol Rhinol (Bord) 128:197–200 Righini CA, Faure C, Karkas A, Schmerber S, Reyt E (2007) Spontaneous perforation in the upper oesophagus resulting from ulcer in heterotopic gastric mucosa. Rev Laryngol Otol Rhinol (Bord) 128:197–200
29.
go back to reference Sataloff RT (2008) Laryngopharyngeal reflux: concepts and controversies. Ear Nose Throat J 87:549–554PubMed Sataloff RT (2008) Laryngopharyngeal reflux: concepts and controversies. Ear Nose Throat J 87:549–554PubMed
30.
go back to reference Tang P, McKinley MJ, Sporrer M, Kahn E (2004) Inlet patch: prevalence, histologic type, and association with esophagitis, Barrett esophagus, and antritis. Arch Pathol Lab Med 128:444–447PubMed Tang P, McKinley MJ, Sporrer M, Kahn E (2004) Inlet patch: prevalence, histologic type, and association with esophagitis, Barrett esophagus, and antritis. Arch Pathol Lab Med 128:444–447PubMed
31.
go back to reference Tauber S, Gross M, Issing WJ (2002) Association of laryngopharyngeal symptoms with gastroesophageal reflux disease. Laryngoscope 112:879–886CrossRefPubMed Tauber S, Gross M, Issing WJ (2002) Association of laryngopharyngeal symptoms with gastroesophageal reflux disease. Laryngoscope 112:879–886CrossRefPubMed
32.
go back to reference Vaezi MF (2008) Laryngeal manifestations of gastroesophageal reflux disease. Curr Gastroenterol Rep 10:271–277CrossRefPubMed Vaezi MF (2008) Laryngeal manifestations of gastroesophageal reflux disease. Curr Gastroenterol Rep 10:271–277CrossRefPubMed
33.
go back to reference von Rahden BH, Stein HJ, Becker K, Liebermann-Meffert D, Siewert JR (2004) Heterotopic gastric mucosa of the esophagus: literature-review and proposal of a clinicopathologic classification. Am J Gastroenterol 99:543–551CrossRef von Rahden BH, Stein HJ, Becker K, Liebermann-Meffert D, Siewert JR (2004) Heterotopic gastric mucosa of the esophagus: literature-review and proposal of a clinicopathologic classification. Am J Gastroenterol 99:543–551CrossRef
34.
go back to reference Waring JP, Wo JM (1997) Cervical esophageal web caused by an inlet patch of gastric mucosa. South Med J 90:554–555PubMed Waring JP, Wo JM (1997) Cervical esophageal web caused by an inlet patch of gastric mucosa. South Med J 90:554–555PubMed
35.
go back to reference Wise SK, Wise JC, DelGaudio JM (2006) Gastroesophageal reflux and laryngopharyngeal reflux in patients with sleep-disordered breathing. Otolaryngol Head Neck Surg 135:253–257CrossRefPubMed Wise SK, Wise JC, DelGaudio JM (2006) Gastroesophageal reflux and laryngopharyngeal reflux in patients with sleep-disordered breathing. Otolaryngol Head Neck Surg 135:253–257CrossRefPubMed
36.
go back to reference Yüksel I, Usküdar O, Köklü S, Başar O, Gültuna S, Unverdi S, Oztürk ZA, Sengül D, Arikök AT, Yüksel O, Coban S (2008) Inlet patch: associations with endoscopic findings in the upper gastrointestinal system. Scand J Gastroenterol 43:910–914CrossRefPubMed Yüksel I, Usküdar O, Köklü S, Başar O, Gültuna S, Unverdi S, Oztürk ZA, Sengül D, Arikök AT, Yüksel O, Coban S (2008) Inlet patch: associations with endoscopic findings in the upper gastrointestinal system. Scand J Gastroenterol 43:910–914CrossRefPubMed
Metadata
Title
Heterotopic gastric mucosal patch of the esophagus is associated with higher prevalence of laryngopharyngeal reflux symptoms
Authors
Vui Heng Chong
Anand Jalihal
Publication date
01-11-2010
Publisher
Springer-Verlag
Published in
European Archives of Oto-Rhino-Laryngology / Issue 11/2010
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-010-1259-2

Other articles of this Issue 11/2010

European Archives of Oto-Rhino-Laryngology 11/2010 Go to the issue