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

par Lechien, Jérôme;Bobin, F.;Mouawad, Francois;Zelenik, Karol;Calvo-Henriquez, Christian;Chiesa-Estomba, Carlos Miguel;Enver, Necati;Nacci, Andrea;Barillari, Maria Rosaria;Schindler, Antonio;Crevier-Buchman, Lise;Hans, Stéphane;Simeone, Virginie;Wlodarczyk, Elzbieta;Harmegnies, Bernard ;Remacle, M. ;Rodriguez, Alexandra;Dequanter, Didier ;Eisendrath, Pierre ;Dapri, Giovanni ;Finck, Camille;Karkos, Petros;Pendleton, Hillevi;Ayad, Tareck;Muls, Vinciane ;Saussez, Sven
Référence European archives of oto-rhino-laryngology, 276, 12, page (3389-3404)
Publication Publié, 2019-12-01

Article révisé par les pairs

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Résumé :

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