With the increasing concern regarding the side effects of long-term Proton Pump Inhibitors, and more recently, ranitidine, there is an increasing need and role for objective reflux testing, as many patients and prescribers are reluctant to commit to long-term anti-reflux medication on clinical grounds alone.
Gastroscopy and nasendoscopy are not reliable diagnostic tests for laryngopharyngeal reflux disease, being negative at least 50% of the time.
At MSAC we provide what is currently considered the gold standard in Laryngopharyngeal reflux testing – the 24 hour dual probe pH / impedance monitoring study. It differs in a key way from more traditional GORD probe testing, in that it measure the pH not only in the lower oesophagus but also in the Pharynx, just above the oesophagus, where LPR reaches. Also, as not all LPR is related to acidic damage, the probe also detects the retrograde movement of liquid from the stomach all the way up the oesophagus and into the pharynx, thus detecting refluxed liquid movement.
After our recent validation study, we are also able to offer a mail-out salivary pepsin test kit (Peptest®), which once returned to us by mail, is analysed in our clinic in order to give a qualitative and quantitative.
Whilst its formal role in LPR testing is yet to be completely established, it serves as a minimally invasive and convenient screening test for patients in whom there is a suspicion of LPR on history +/- examination…
If this test is negative, and patients or their doctors are still suspicious of LPR causing symptoms, then the slightly more invasive, 24 hour dual probe pH / impedance test is recommended – which requires an in-person visit to our rooms.