{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:54:55Z","timestamp":1784523295651,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T00:00:00Z","timestamp":1591574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"IRIS Grant","award":["2018"],"award-info":[{"award-number":["2018"]}]},{"name":"VESALE GRANT 2017","award":["2017"],"award-info":[{"award-number":["2017"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To assess the impact of diet on the saliva pepsin concentration of patients with laryngopharyngeal reflux (LPR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Non\u2010controlled Prospective Study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with positive LPR regarding hypopharyngeal\u2013esophageal impedance\u2010pH monitoring (HEMII\u2010pH) were enrolled from three European Hospitals. Patients collected three saliva samples, respectively, in the morning (fasting), and 1 to 2\u2009hour after lunch and dinner. Patients carefully detailed foods and beverages consumed during meals and before the pepsin samples. The 3\u2010month treatment was based on the association of diet, proton pump inhibitors, alginate, or magaldrate regarding the HEMII\u2010pH characteristics. Reflux Symptom Score (RSS) and Reflux Sign Assessment (RSA) were used for assessing the pre\u2010 to posttreatment clinical evolution. The Refluxogenic Diet Score and the Refluxogenic Score of a Dish (RESDI) were used to assess the refluxogenic potential of foods and beverages. The relationship between saliva pepsin concentration, HEMII\u2010pH, RESDI, RSS, and RSA was investigated through multiple linear regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two patients were included. The saliva pepsin concentration of the 24\u2010hour period of testing was significantly associated with foods and beverages consumed during the testing period and the evening dinner (<jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub> = 0.973, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). RSS and RSA significantly improved throughout treatment. The level of saliva pepsin in the morning was a negative predictive factor of the therapeutic response regarding RSA and RSS (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Foods and beverages may significantly impact the saliva pepsin concentration of patients with LPR. Patients with high\u2010level saliva pepsin in the morning had lower therapeutic response compared with those with low\u2010level saliva pepsin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:350\u2013359, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28756","type":"journal-article","created":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T13:09:21Z","timestamp":1591621761000},"page":"350-359","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Saliva Pepsin Concentration of Laryngopharyngeal Reflux Patients Is Influenced by Meals Consumed Before the Samples"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-0845","authenticated-orcid":false,"given":"Jerome R.","family":"Lechien","sequence":"first","affiliation":[{"name":"Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto\u2010Rhino\u2010Laryngological Societies  Paris France"},{"name":"Department of Human Anatomy and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons  Mons Belgium"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Foch Hospital, School of Medicine, UFR Simone Veil, Universit\u00e9 Versailles Saint\u2010Quentin\u2010en\u2010Yvelines (Paris Saclay University)  Paris France"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery CHU de Bruxelles, CHU Saint\u2010Pierre, School of Medicine, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Bobin","sequence":"additional","affiliation":[{"name":"Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto\u2010Rhino\u2010Laryngological Societies  Paris France"},{"name":"Department of Otolaryngology Polyclinique Elsan de Poitiers  Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinciane","family":"Muls","sequence":"additional","affiliation":[{"name":"Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto\u2010Rhino\u2010Laryngological Societies  Paris France"},{"name":"Department of Gastroenterology CHU Saint\u2010Pierre, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Horoi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery CHU de Bruxelles, CHU Saint\u2010Pierre, School of Medicine, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Paule","family":"Thill","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery CHU de Bruxelles, CHU Saint\u2010Pierre, School of Medicine, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Dequanter","sequence":"additional","affiliation":[{"name":"Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto\u2010Rhino\u2010Laryngological Societies  Paris France"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery CHU de Bruxelles, CHU Saint\u2010Pierre, School of Medicine, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Finck","sequence":"additional","affiliation":[{"name":"Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto\u2010Rhino\u2010Laryngological Societies  Paris France"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery CHU de Li\u00e8ge, University of Li\u00e8ge  Li\u00e8ge Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto\u2010Rhino\u2010Laryngological Societies  Paris France"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery CHU de Bruxelles, CHU Saint\u2010Pierre, School of Medicine, Universit\u00e9 Libre de Bruxelles  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Saussez","sequence":"additional","affiliation":[{"name":"Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto\u2010Rhino\u2010Laryngological Societies  Paris France"},{"name":"Department of Human Anatomy and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons  Mons Belgium"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery CHU de Bruxelles, CHU Saint\u2010Pierre, School of Medicine, Universit\u00e9 Libre de Bruxelles  Brussels 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