‘Persistent throat symptoms’ versus ‘laryngopharyngeal reflux’: a cross-sectional study refining the clinical condition

Objective Many patients are assessed for chronic symptoms including: dysphonia, ‘globus’, throat clearing, postnasal secretions and cough; commonly grouped together and attributed to ‘laryngopharyngeal reflux’. This study aimed to explore a clinical trial’s baseline dataset for patterns of presentin...

Full description

Saved in:
Bibliographic Details
Main Authors: Louise Hayes, Janet Wilson, Holly Fisher, James O'Hara
Format: Article
Language:English
Published: BMJ Publishing Group 2022-10-01
Series:BMJ Open Gastroenterology
Online Access:https://bmjopengastro.bmj.com/content/9/1/e000850.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849690145023852544
author Louise Hayes
Janet Wilson
Holly Fisher
James O'Hara
author_facet Louise Hayes
Janet Wilson
Holly Fisher
James O'Hara
author_sort Louise Hayes
collection DOAJ
description Objective Many patients are assessed for chronic symptoms including: dysphonia, ‘globus’, throat clearing, postnasal secretions and cough; commonly grouped together and attributed to ‘laryngopharyngeal reflux’. This study aimed to explore a clinical trial’s baseline dataset for patterns of presenting symptoms, which might provide a more rational basis for treatment.Design Baseline data were analysed for participants entering the Trial Of Proton-Pump Inhibitors in Throat Symptoms: age, body mass index, Reflux Symptom Index, Comprehensive Reflux Symptom Score, Laryngopharyngeal Reflux-Health-related Quality of Life questionnaire and Reflux Finding Score (RFS-endoscopic examination). The relationships between the questionnaires and demographic factors were assessed. Exploratory factor analysis (EFA) was conducted on individual symptom items in the combined questionnaires. The EFA factors were applied to a Cluster Analysis of participants, to explore the presence of identifiable patient.Results Throat clearing and globus were the highest ranked scores in the 344 participants. Increasing age was inversely associated with symptom severity (p<0.01). There was no relationship between the RFS and any of the three questionnaires. EFA resulted in a seven-factor model with clinically meaningful labels: voice, cough, gastrointestinal symptoms, airway symptoms and dysphagia, throat clearing, lump in throat, and life events. Cluster analysis failed to demonstrate any clinically meaningful clusters of patients.Conclusion This study offers a framework for future research and demonstrates that individual symptoms cannot be used to group patients. The analysis supports the use of a broad ‘umbrella’ term such as persistent throat symptoms.Trial registration number ISRCTN38578686.
format Article
id doaj-art-f66ee7c4ed064c3bbd2affdb4294bc68
institution DOAJ
issn 2054-4774
language English
publishDate 2022-10-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open Gastroenterology
spelling doaj-art-f66ee7c4ed064c3bbd2affdb4294bc682025-08-20T03:21:24ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742022-10-019110.1136/bmjgast-2021-000850‘Persistent throat symptoms’ versus ‘laryngopharyngeal reflux’: a cross-sectional study refining the clinical conditionLouise Hayes0Janet Wilson1Holly Fisher2James O'Hara35 Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK2 Genitourinary Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UKPopulation Health Sciences, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK13 Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UKObjective Many patients are assessed for chronic symptoms including: dysphonia, ‘globus’, throat clearing, postnasal secretions and cough; commonly grouped together and attributed to ‘laryngopharyngeal reflux’. This study aimed to explore a clinical trial’s baseline dataset for patterns of presenting symptoms, which might provide a more rational basis for treatment.Design Baseline data were analysed for participants entering the Trial Of Proton-Pump Inhibitors in Throat Symptoms: age, body mass index, Reflux Symptom Index, Comprehensive Reflux Symptom Score, Laryngopharyngeal Reflux-Health-related Quality of Life questionnaire and Reflux Finding Score (RFS-endoscopic examination). The relationships between the questionnaires and demographic factors were assessed. Exploratory factor analysis (EFA) was conducted on individual symptom items in the combined questionnaires. The EFA factors were applied to a Cluster Analysis of participants, to explore the presence of identifiable patient.Results Throat clearing and globus were the highest ranked scores in the 344 participants. Increasing age was inversely associated with symptom severity (p<0.01). There was no relationship between the RFS and any of the three questionnaires. EFA resulted in a seven-factor model with clinically meaningful labels: voice, cough, gastrointestinal symptoms, airway symptoms and dysphagia, throat clearing, lump in throat, and life events. Cluster analysis failed to demonstrate any clinically meaningful clusters of patients.Conclusion This study offers a framework for future research and demonstrates that individual symptoms cannot be used to group patients. The analysis supports the use of a broad ‘umbrella’ term such as persistent throat symptoms.Trial registration number ISRCTN38578686.https://bmjopengastro.bmj.com/content/9/1/e000850.full
spellingShingle Louise Hayes
Janet Wilson
Holly Fisher
James O'Hara
‘Persistent throat symptoms’ versus ‘laryngopharyngeal reflux’: a cross-sectional study refining the clinical condition
BMJ Open Gastroenterology
title ‘Persistent throat symptoms’ versus ‘laryngopharyngeal reflux’: a cross-sectional study refining the clinical condition
title_full ‘Persistent throat symptoms’ versus ‘laryngopharyngeal reflux’: a cross-sectional study refining the clinical condition
title_fullStr ‘Persistent throat symptoms’ versus ‘laryngopharyngeal reflux’: a cross-sectional study refining the clinical condition
title_full_unstemmed ‘Persistent throat symptoms’ versus ‘laryngopharyngeal reflux’: a cross-sectional study refining the clinical condition
title_short ‘Persistent throat symptoms’ versus ‘laryngopharyngeal reflux’: a cross-sectional study refining the clinical condition
title_sort persistent throat symptoms versus laryngopharyngeal reflux a cross sectional study refining the clinical condition
url https://bmjopengastro.bmj.com/content/9/1/e000850.full
work_keys_str_mv AT louisehayes persistentthroatsymptomsversuslaryngopharyngealrefluxacrosssectionalstudyrefiningtheclinicalcondition
AT janetwilson persistentthroatsymptomsversuslaryngopharyngealrefluxacrosssectionalstudyrefiningtheclinicalcondition
AT hollyfisher persistentthroatsymptomsversuslaryngopharyngealrefluxacrosssectionalstudyrefiningtheclinicalcondition
AT jamesohara persistentthroatsymptomsversuslaryngopharyngealrefluxacrosssectionalstudyrefiningtheclinicalcondition