Hisham Wehbe, MD1, Hussam Kawas, MD1, Chao Tu, 1, Qijun Yang, MS2, Claire Beveridge, MD2 1Cleveland Clinic Foundation, Cleveland, OH; 2Cleveland Clinic, Cleveland, OH Introduction: Laryngopharyngeal reflux (LPR) is a challenging clinical entity to diagnose due to the absence of standardized diagnostic criteria. While acid exposure time (AET) is a validated metric in gastroesophageal reflux disease (GERD), its role in diagnosing LPR remains unclear. Given the heightened sensitivity of laryngeal tissue to acid compared with esophageal tissue, we hypothesize that LPR may be identified with a lower AET compared with GERD. Our study aims to assess an AET threshold that captures majority of LPR cases. Methods: We performed a retrospective analysis of adult patients who were diagnosed in otolaryngology clinic with LPR and had pH testing between the dates of 03/2005-11/2023. Exclusion criteria included head and neck cancer, history of radiation, and eosinophilic esophagitis. Patient charts were reviewed for relevant data, including demographics, symptoms, pH testing results, endoscopic findings, and histology. Analysis includes descriptive statistics. Results: There were 47 patients who met criteria for the study. Clinical characteristics are listed in Table 1. Bravo testing was performed in 85% of patients, while pH impedance catheter testing was used in 15% of patients. 29.7% of tested patients had an abnormal acid exposure time (AET) ( >6%) per GERD criteria. On acid suppression therapy, 44.7% of patients experienced symptomatic and 29.8% laryngoscopic improvement. Mean AET testing was ≥5.4% (Table 2). Discussion: Mean AET threshold was elevated in LPR patients, suggesting that pH testing may be a useful marker. Further studies are needed to assess an exact AET threshold for diagnosis of LPR.
Figure: Table 1. Demographics and Lifestyle Characteristics
Figure: Table 2. PH Testing and Treatment Outcomes
Disclosures: Hisham Wehbe indicated no relevant financial relationships. Hussam Kawas indicated no relevant financial relationships. Chao Tu indicated no relevant financial relationships. Qijun Yang indicated no relevant financial relationships. Claire Beveridge: Asofarma – invited talk for a national society conference. Bionest – Consultant. Gastrogirl – invited podcast talk. Guidepoint – Consultant. Sanofi – Advisory Committee/Board Member. Takeda – Consultant.
Hisham Wehbe, MD1, Hussam Kawas, MD1, Chao Tu, 1, Qijun Yang, MS2, Claire Beveridge, MD2. P2766 - Evaluating Acid Exposure Time Thresholds in the Diagnosis of Laryngopharyngeal Reflux, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
