Posterior laryngitis: a disease with different aetiologies affecting health-related quality of life:a prospective case–control study

Background: Laryngo-pharyngeal reflux (LPR) is assumed to be the most common cause of posterior laryngitis (PL).
Since LPR is found in healthy subjects, and PL patients are not improved by acid-reducing therapy, other
aetiologies to PL must be considered. The aims of this study in PL were to investigate the prevalence of acid reflux
in the proximal oesophagus and functional gastrointestinal symptoms, to analyse motilin levels in plasma, and to
assess health-related quality of life (HRQOL) before and after treatment.
Methods: Forty-six patients (26 women), with verified PL, median age 55 (IQR 41–68) years, were referred to
oesophago-gastro-duodenoscopy and 24-h pH monitoring. Plasma motilin was analysed. The 36-item Short-Form
questionnaire was completed at inclusion and at follow-up after 43±14 months, when also the Visual Analogue
Scale for Irritable Bowel Syndrome was completed. Values were compared to controls. Treatment and relief of
symptoms were noted from medical records.
Results: Thirty-four percent had proximal acid reflux and 40% showed signs of distal reflux. Ninety-four percent received
acid-reducing treatment, with total relief of symptoms in 17%. Patients with reflux symptoms had lower plasma motilin
levels compared to patients without reflux symptoms (p = 0.021). The HRQOL was impaired at inclusion, but improved
over time. Patients, especially men, had more functional gastrointestinal symptoms than controls.
Conclusions: This study indicates that a minority of patients with PL has LPR and is cured by acid-reducing therapy.
Disturbed plasma motilin levels and presence of functional gastrointestinal symptoms are found in PL. The impaired
HRQOL improves over time.