Nonsteriodal Antiinflamatory Drugs As A Risk Factor Of Gastro-Oesophageal Reflux Oesophagitis, And Posterior Laryngitis In Arthritic Patients

Abstract

Non steroidal anti inflammatory drugs (NSAIDs) are known to cause ulcers of the stomach and to a lesser degree, the duodenum. Consumption of NSAIDs has been associated with the infrequent occurrence of ulcers at other locations, such as the jejunum, ileum and colon. Several studies have suggested that consumption of NSAIDS also constitutes a risk factor for the development of erosive oesophagitis, including oesophageal strictures. It is now documented that NSAIDS are associated with gastro- oesophageal reflux disease (GERD). It was found recently that GERD is associated with a variety of laryngeal conditions and symptoms, of which “reflux laryngitis” is the most common. AIM OF THE WORK: is to study the effect of NSAIDs on the development of laryngitis in patients with GERD. PATIENTS AND METHODS: study included 60 patients, 42 males and 18 females aged between 26 – 52 years old (mean 37.9), a detailed history was taken from all patients. All the sixty patients were suspected to have GERD based on symptoms including acid reflux, Group I: - 40 patients were receiving daily-recommended doses of NSAIDs for at least one month for a diagnosed rheumatological disease, Group II: - 20 patients who were diagnosed as GERD, and were not receiving any NSAIDs for at least one month prior to the present study. The sixty patients were subjected to upper gastrointestinal endoscopy. Patients who were diagnosed as GERD with or without oesophagitis were subjected to ENT fibro-optic laryngoscopy. RESULTS: 42% of all patients with GERD have hoarseness of voice, 30% have recurrent chocking, 53% have excessive throat cleaning. Postglottic oedema, arytenoid oedema, vocal fold oedema, were all significantly higher in group I than in group II. CONCLUSION: The chronic use of NSAIDs can be considered as a risk factor for developing GERD, erosive oesophagitis with or without subsequent posterior laryngitis. Laryngoscopy may have a predictive value for the occurrence of GERD in those patients. Patients who were on regular use of NSAIDS, and are symptomatic for GERD are recommended to start medical treatment for GERD to guard against erosive oesophagitis and/or posterior laryngitis.