Pharyngeal swallow in gastroesophageal reflux disease

Outside of the otolaryngologic literature it is not generally recognized that symptoms of gastroesophageal reflux are associated with abnormalities in the larynx and pharynx. Published data of videorecordings of the normal pharyngeal swallow in 16 patients asymptomatic for dysphagia or gastroesophageal reflux were compared to data from recordings from a second group of 70 patients, who were symptomatic for dysphagia or gastroesophageal reflux. Both groups were timed in a similar manner, and the timing data were compared by Student t-test to determine if functional variations between the groups existed. Fifty-eight timed events occurring during the swallowing process, 23 in the anterior view and 35 in the lateral view, were analyzed. A comparison of events occurring before and after bolus arrival in the esophagus was made. Eighteen percent of events in the pre-esophageal period occurred significantly earlier (p<0.05) in the symptomatic group. Marked differences were seen after the bolus entered the esophagus as 39% of events occurred significantly later in the symptomatic group. Our data suggest that individuals with symptoms of gastroesophageal reflux disease demonstrate a number of functional variations during the pharyngeal swallow. This finding is consistent with structural changes described in the otolaryngologic literature.