{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:10:49Z","timestamp":1789002649455,"version":"build-2803163510"},"reference-count":55,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The diagnosis of gastro\u2010oesophageal reflux disease (GERD) based on otolaryngologist's assessment of laryngoscopic findings remains contentious in terms of sensitivity and specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate GERD prevalence, applying Lyon 2.0 Consensus criteria, in patients with extra\u2010oesophageal symptoms undergoing laryngoscopic examination and impedance\u2010pH monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective assessment, we included 470 patients with extra\u2010oesophageal symptoms, either isolated or combined with typical symptoms, who had been referred to six tertiary Italian Gastroenterology Units between January and December 2020. Of these, 274 underwent 24\u2010h impedance\u2010pH monitoring and laryngoscopy off PPI therapy. GERD diagnosis followed Lyon Consensus 2.0 criteria, incorporating mean nocturnal baseline impedance when pH\u2010impedance monitoring was inconclusive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Laryngoscopic examination revealed pathological findings (predominantly posterior laryngitis) in 71.2% (195\/274). GERD was diagnosed in 29.2% (80\/274) via impedance\u2010pH monitoring. The prevalence of GERD in patients with positive or negative laryngoscopy was similar (32.3% vs. 21.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.075). No significant difference in proximal reflux occurrences was noted between positive and negative laryngoscopy groups (33.3% vs. 24.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.133). Laryngoscopy demonstrated sensitivity and specificity of 78.8% and 32.0%, respectively, with a positive predictive value (PPV) of 32.3% and negative predictive value (NPV) of 28.4%. In contrast, a threshold of four concurrent laryngoscopic signs, identified in only eight patients, demonstrated a PPV of 93.8% and a NPV of 73.6% (sensitivity 25.4%, specificity 99.2%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study underscores the limited diagnostic accuracy of laryngoscopy, emphasising the necessity of impedance\u2010pH monitoring for confirming GERD diagnoses using Lyon 2.0 criteria in patients with suspected extra\u2010oesophageal symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.17934","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T11:10:04Z","timestamp":1709723404000},"page":"1134-1143","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Applying Lyon consensus criteria in the work\u2010up of patients with extra<scp>\u2010oesophageal<\/scp> symptoms \u2013 A multicentre retrospective 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