Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo

Detalhes bibliográficos
Ano de defesa: 2020
Autor(a) principal: Pompeu, Clara Mota Randal
Orientador(a): Souza, Marcellus Henrique Loiola Ponte de
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://www.repositorio.ufc.br/handle/riufc/53909
Resumo: The laryngopharyngeal reflux disease (LPRD) is defined as aerodigestive signs and symptoms secondary to laryngeal and pharyngeal mucosa damage, due to gastrointestinal content reflux. LPRD is a new entity and was originally described as an extraesophageal manifestation of gastroesophageal reflux disease (GERD). LPRD is a rather prevalent condition, and dysphonia is an important symptom. This study aimed to evaluate the therapeutic response to a proton pump inhibitor (PPI) treatment, in dysphonic patients with LPRD, applying standardized scores. It was also evaluated if higher levels of the basal scores could predict a better response to the PPI treatment. A group of 21 patients with chronic dysphonia, over three weeks, were analyzed by Reflux disease questionnaire (RDQ), Reflux symptom index (RSI) and Reflux finding score (RFS). Patients were treated with pantoprazole 40mg, twice a day, for eight weeks, and it was considered as response a reduction of at least 50% of the scores, when compared to the basal results. After the course of treatment, there was a significant reduction of all the scores, however the clinical responses were higher than the laryngoscopic response. Higher scores in the RFS items erythema/hyperemia and diffuse laryngeal edema, before treatment, were present is the patients with better laryngoscopic response to the PPI. On the other hand, higher scores in the RFS item erythema/hyperemia, before treatment, were present in the patients with better complete response (clinical and laryngoscopic) to the PPI treatment. None of the scores before treatment was associated with better clinical response to the PPI. As conclusion, this study shows that there is a therapeutic response to PPI in dysphonic patients with LPRD, with the clinical response higher than the laryngoscopic one, after eight weeks. Higher scores of erythema/hyperemia before treatment were present in patients with a better complete response to the PPI. Further placebo-controlled studies, with a longer period of treatment, are necessary to confirm these results.
id UFC-7_ee10c9c4b8dd8d233e8fd20ba9076ea8
oai_identifier_str oai:repositorio.ufc.br:riufc/53909
network_acronym_str UFC-7
network_name_str Repositório Institucional da Universidade Federal do Ceará (UFC)
repository_id_str
spelling Pompeu, Clara Mota RandalBorsaro, Aline Almeida FigueiredoSouza, Marcellus Henrique Loiola Ponte de2020-09-10T11:43:08Z2020-09-10T11:43:08Z2020POMPEU, C. M. R. Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo. 2020. 67 f. Dissertação (Mestrado em Ciências Médico-Cirúrgicas) – Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2020.http://www.repositorio.ufc.br/handle/riufc/53909The laryngopharyngeal reflux disease (LPRD) is defined as aerodigestive signs and symptoms secondary to laryngeal and pharyngeal mucosa damage, due to gastrointestinal content reflux. LPRD is a new entity and was originally described as an extraesophageal manifestation of gastroesophageal reflux disease (GERD). LPRD is a rather prevalent condition, and dysphonia is an important symptom. This study aimed to evaluate the therapeutic response to a proton pump inhibitor (PPI) treatment, in dysphonic patients with LPRD, applying standardized scores. It was also evaluated if higher levels of the basal scores could predict a better response to the PPI treatment. A group of 21 patients with chronic dysphonia, over three weeks, were analyzed by Reflux disease questionnaire (RDQ), Reflux symptom index (RSI) and Reflux finding score (RFS). Patients were treated with pantoprazole 40mg, twice a day, for eight weeks, and it was considered as response a reduction of at least 50% of the scores, when compared to the basal results. After the course of treatment, there was a significant reduction of all the scores, however the clinical responses were higher than the laryngoscopic response. Higher scores in the RFS items erythema/hyperemia and diffuse laryngeal edema, before treatment, were present is the patients with better laryngoscopic response to the PPI. On the other hand, higher scores in the RFS item erythema/hyperemia, before treatment, were present in the patients with better complete response (clinical and laryngoscopic) to the PPI treatment. None of the scores before treatment was associated with better clinical response to the PPI. As conclusion, this study shows that there is a therapeutic response to PPI in dysphonic patients with LPRD, with the clinical response higher than the laryngoscopic one, after eight weeks. Higher scores of erythema/hyperemia before treatment were present in patients with a better complete response to the PPI. Further placebo-controlled studies, with a longer period of treatment, are necessary to confirm these results.A doença do refluxo faringolaríngeo (DRFL) é definida como sinais e sintomas do trato aerodigestivo, decorrentes do dano à mucosa faríngea e laríngea, por refluxo de conteúdo gastrointestinal. DRFL é um diagnóstico novo e foi inicialmente descrita como uma manifestação extraesofágica da doença do refluxo gastroesofágico (DRGE). DRFL é condição bastante prevalente, sendo a disfonia um sintoma de destaque. O objetivo deste trabalho foi avaliar a resposta terapêutica a um inibidor de bomba de prótons (IBP), em pacientes disfônicos com DRFL, através da utilização de escores padronizados. Ademais, foi avaliado se níveis mais elevados dos escores basais poderiam prever uma melhor resposta ao IBP. Foram analisados 21 pacientes com disfonia crônica, superior a três semanas, com aplicação do Questionário padronizado de DRGE (RDQ), do Índice de sintomas de refluxo (ISR) e da Escala de achados endolaríngeos de refluxo (EAER). Os pacientes foram tratados com pantoprazol 40mg, duas vezes ao dia, por oito semanas, sendo considerada resposta a redução dos escores em pelo menos 50% em relação ao basal. Ao final do tratamento, houve queda significativa dos escores em todos os questionários, entretanto as respostas clínicas foram maiores do que a resposta laringoscópica. Pontuações mais elevadas nos itens eritema/hiperemia e edema laríngeo difuso da EAER, antes do tratamento, estiveram presentes nos pacientes com melhor resposta laringoscópica ao IBP. Por outro lado, apenas pontuações mais elevadas do item eritema/hiperemia, antes do tratamento, foram capazes de predizer melhor resposta total (clínica e laringoscópica) dos pacientes ao IBP. Não houve nenhum escore antes do tratamento que se associou com uma melhor resposta clínica ao IBP. Como conclusão, o trabalho mostra que há uma resposta terapêutica ao IBP em pacientes disfônicos com DRFL, sendo a resposta clínica maior que a laringoscópica, após oito semanas. Pontuações mais elevadas de eritema/hiperemia antes do tratamento estiveram presentes nos pacientes com melhor resposta total ao IBP. Novos estudos placebo controlados, com maior tempo de tratamento, são necessários para confirmar estes resultados.Conteúdo GastrointestinalDisfoniaMucosa LaríngeaResposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisporreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccessORIGINAL2020_dis_cmrpompeu.pdf2020_dis_cmrpompeu.pdfapplication/pdf1278802http://repositorio.ufc.br/bitstream/riufc/53909/1/2020_dis_cmrpompeu.pdfc70a220e0961e8e3873e55cbad23a2d5MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repositorio.ufc.br/bitstream/riufc/53909/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52riufc/539092020-09-10 08:43:09.074oai:repositorio.ufc.br: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Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2020-09-10T11:43:09Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.pt_BR.fl_str_mv Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo
title Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo
spellingShingle Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo
Pompeu, Clara Mota Randal
Conteúdo Gastrointestinal
Disfonia
Mucosa Laríngea
title_short Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo
title_full Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo
title_fullStr Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo
title_full_unstemmed Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo
title_sort Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo
author Pompeu, Clara Mota Randal
author_facet Pompeu, Clara Mota Randal
author_role author
dc.contributor.co-advisor.none.fl_str_mv Borsaro, Aline Almeida Figueiredo
dc.contributor.author.fl_str_mv Pompeu, Clara Mota Randal
dc.contributor.advisor1.fl_str_mv Souza, Marcellus Henrique Loiola Ponte de
contributor_str_mv Souza, Marcellus Henrique Loiola Ponte de
dc.subject.por.fl_str_mv Conteúdo Gastrointestinal
Disfonia
Mucosa Laríngea
topic Conteúdo Gastrointestinal
Disfonia
Mucosa Laríngea
description The laryngopharyngeal reflux disease (LPRD) is defined as aerodigestive signs and symptoms secondary to laryngeal and pharyngeal mucosa damage, due to gastrointestinal content reflux. LPRD is a new entity and was originally described as an extraesophageal manifestation of gastroesophageal reflux disease (GERD). LPRD is a rather prevalent condition, and dysphonia is an important symptom. This study aimed to evaluate the therapeutic response to a proton pump inhibitor (PPI) treatment, in dysphonic patients with LPRD, applying standardized scores. It was also evaluated if higher levels of the basal scores could predict a better response to the PPI treatment. A group of 21 patients with chronic dysphonia, over three weeks, were analyzed by Reflux disease questionnaire (RDQ), Reflux symptom index (RSI) and Reflux finding score (RFS). Patients were treated with pantoprazole 40mg, twice a day, for eight weeks, and it was considered as response a reduction of at least 50% of the scores, when compared to the basal results. After the course of treatment, there was a significant reduction of all the scores, however the clinical responses were higher than the laryngoscopic response. Higher scores in the RFS items erythema/hyperemia and diffuse laryngeal edema, before treatment, were present is the patients with better laryngoscopic response to the PPI. On the other hand, higher scores in the RFS item erythema/hyperemia, before treatment, were present in the patients with better complete response (clinical and laryngoscopic) to the PPI treatment. None of the scores before treatment was associated with better clinical response to the PPI. As conclusion, this study shows that there is a therapeutic response to PPI in dysphonic patients with LPRD, with the clinical response higher than the laryngoscopic one, after eight weeks. Higher scores of erythema/hyperemia before treatment were present in patients with a better complete response to the PPI. Further placebo-controlled studies, with a longer period of treatment, are necessary to confirm these results.
publishDate 2020
dc.date.accessioned.fl_str_mv 2020-09-10T11:43:08Z
dc.date.available.fl_str_mv 2020-09-10T11:43:08Z
dc.date.issued.fl_str_mv 2020
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv POMPEU, C. M. R. Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo. 2020. 67 f. Dissertação (Mestrado em Ciências Médico-Cirúrgicas) – Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2020.
dc.identifier.uri.fl_str_mv http://www.repositorio.ufc.br/handle/riufc/53909
identifier_str_mv POMPEU, C. M. R. Resposta terapêutica a inibidor de bomba de prótons em pacientes com disfonia e doença do refluxo faringolaríngeo. 2020. 67 f. Dissertação (Mestrado em Ciências Médico-Cirúrgicas) – Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2020.
url http://www.repositorio.ufc.br/handle/riufc/53909
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:Repositório Institucional da Universidade Federal do Ceará (UFC)
instname:Universidade Federal do Ceará (UFC)
instacron:UFC
instname_str Universidade Federal do Ceará (UFC)
instacron_str UFC
institution UFC
reponame_str Repositório Institucional da Universidade Federal do Ceará (UFC)
collection Repositório Institucional da Universidade Federal do Ceará (UFC)
bitstream.url.fl_str_mv http://repositorio.ufc.br/bitstream/riufc/53909/1/2020_dis_cmrpompeu.pdf
http://repositorio.ufc.br/bitstream/riufc/53909/2/license.txt
bitstream.checksum.fl_str_mv c70a220e0961e8e3873e55cbad23a2d5
8a4605be74aa9ea9d79846c1fba20a33
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
repository.name.fl_str_mv Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)
repository.mail.fl_str_mv bu@ufc.br || repositorio@ufc.br
_version_ 1847793227333107712