ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Autonomic dysfunction in laryngopharyngeal reflux: heart rate variability and its association with esophageal motility.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
aimsLaryngopharyngeal reflux disease (LPRD) has been associated with dysfunction of the autonomic nervous system (ANS), which may contribute to esophageal motility disorders and reflux events. However, the interactions between ANS function, esophageal motility, and psychological factors in LPRD remain poorly understood. This study aims to investigate ANS dysfunction in LPRD and its relationship with esophageal motility and reflux symptoms.
methodsHeart rate variability (HRV) analysis was conducted to assess ANS function in LPRD patients and healthy controls at rest. The impact of acid-base reflux on ANS activity was evaluated using pH-specific beverage challenge tests. Esophageal motility parameters were analyzed in relation to ANS function.
resultsLPRD patients exhibited reduced vagal and sympathetic activity at rest compared to controls. Although LPRD patients with elevated upper esophageal sphincter pressure (UESP) showed a trend toward higher overall autonomic activity, and those with decreased lower esophageal sphincter pressure (LESP) exhibited concurrent increases in both sympathetic and vagal activity, these differences were not statistically significant. Impaired peristalsis indicated diminished vagal function. LPRD patients reported higher levels of depression (45.09 ± 11.00 vs. 37.38 ± 12.85, P = 0.001) and anxiety (42.83 ± 9.19 vs. 36.5 ± 9.44, P = 0.001), with anxiety correlating with reflux severity.
conclusionsLPRD is associated with autonomic dysfunction, reduced vagal activity, esophageal motility disturbances, and reflux events. Psychological factors, particularly anxiety and depression, may exacerbate the condition. Monitoring ANS function and incorporating targeted interventions could improve treatment outcomes and quality of life for LPRD patients.
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