Abstract: Objective To examine the effect of Helicobacter pylori(HP)infection on the salivary pepsin concentration in patients with symptomatic laryngopharyngeal reflux(LPR). Methods We enrolled 229 newly diagnosed outpatients with LPR who complained of non-specific symptoms, including pharyngeal foreign body sensation and repeated throat clearing. HP infection was confirmed by performing a ¹⁴C breath test, and patients in the HP-positive and HP-negative groups were prescribed HP eradication treatment(triple therapy)and proton pump inhibitors, respectively. Saliva samples were collected from all patients at initial diagnosis and post-treatment follow-ups(the HP-positive group underwent the ¹⁴C breath test at follow-up visits), and differences in the reflux symptom index(RSI)score, the reflux finding score(RFS)score, and salivary pepsin concentration were compared before and after treatment. Results There were no significant differences in total RSI and RFS scores between HP-positive and HP-negative patients with LPR(11.00 vs 9.00, P=0.077; 8.50 vs 9.00, P=0.415). However, scores for symptoms and signs such as hoarseness(P=0.005), annoying cough(P=0.016), vocal cord edema(P=0.002), and salivary pepsin concentration(94.90 μg/mL vs 45.28 μg/mL, P<0.001)were significantly higher in HP-positive patients than those in HP-negative patients with LPR. Furthermore, compared with HP-negative patients with LPR, HP-positive patients exhibited a more significant reduction in RSI and RFS scores and salivary pepsin concentrations after treatment(P=0.012,P=0.019,P=0.013,P=0.027). Conclusion HP eradication therapy could significantly reduce scores of specific symptoms and signs, as well as the salivary pepsin concentration in HP-infected patients with LPR, suggesting that HP infection plays an important role in the pathogenesis of LPR.

Key words: Helicobacter pylori infection, Laryngopharyngeal reflux, Saliva pepsin, Reflux symptom index, Reflux finding score