喉頭咽頭逆流症患者の食事の逆流性を評価するスコアの開発

Development of scores assessing the refluxogenic potential of diet of patients with laryngopharyngeal reflux.

• Jerome R Lechien
• Francois Bobin
• Francois Mouawad
• Karol Zelenik
• Christian Calvo-Henriquez
• Carlos M Chiesa-Estomba
• Necati Enver
• Andrea Nacci
• Maria Rosaria Barillari
• Antonio Schindler
• Lise Crevier-Buchman
• Stéphane Hans
• Virginie Simeone
• Elzbieta Wlodarczyk
• Bernard Harmegnies
• Marc Remacle
• Alexandra Rodriguez
• Didier Dequanter
• Pierre Eisendrath
• Giovanni Dapri
• Camille Finck
• Petros Karkos
• Hillevi Pendleton
• Tareck Ayad
• Vinciane Muls
• Sven Saussez

抄録

目的:

OBJECTIVE: To develop clinical tools assessing the refluxogenic potential of foods and beverages (F&B) consumed by patients with laryngopharyngeal reflux (LPR).

方法:

METHODS: European experts of the LPR Study group of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological societies were invited to identify the components of Western European F&B that would be associated with the development of LPR. Based on the list generated by experts, four authors conducted a systematic review to identify the F&B involved in the development of esophageal sphincter and motility dysfunctions, both mechanisms involved in the development of gastroesophageal reflux disease and LPR. Regarding the F&B components and the characteristics identified as important in the development of reflux, experts developed three rational scores for the assessment of the refluxogenic potential of F&B, a dish, or the overall diet of the patient.

結果:

この研究には欧州の専門家26名が参加し、LPRの発症に重要なF&Bの以下の成分を同定しました：pH。

RESULTS: Twenty-six European experts participated to the study and identified the following components of F&B as important in the development of LPR: pH; lipid, carbohydrate, protein composition; fiber composition of vegetables; alcohol degree; caffeine/theine composition; and high osmolality of beverage. A total of 72 relevant studies have contributed to identifying the Western European F&B that are highly susceptible to be involved in the development of reflux. The F&B characteristics were considered for developing a Refluxogenic Diet Score (REDS), allowing a categorization of F&B into five categories ranging from 1 (low refluxogenic F&B) to 5 (high refluxogenic F&B). From REDS, experts developed the Refluxogenic Score of a Dish (RESDI) and the Global Refluxogenic Diet Score (GRES), which allow the assessment of the refluxogenic potential of dish and the overall diet of the LPR patient, respectively.

結論:

CONCLUSION: REDS, RESDI and GRES are proposed as objective scores for assessing the refluxogenic potential of F&B composing a dish or the overall diet of LPR patients. Future studies are needed to study the correlation between these scores and the development of LPR according to impedance-pH study.