Differences

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--- gor [2026/08/01 13:04] – [gastro-oesophageal reflux] gary1
+++ gor [2026/08/02 06:53] (current) – [introduction] gary1
@@ Line 36: / Line 36: @@
   *although [[ppis]] can give symptom control of erosive GOR even after 4 weeks of standard dose Rx, if Rx is discontinued, GOR will relapse in 75% of patients within 6 months (([[http://www.nature.com/gimo/contents/pt1/full/gimo42.html]]))
   ***pepsin-related inflammation**
-    * some patients despite being on [[PPIs]] develop injury to the vocal folds in laryngopharyngeal reflux (LPR) primarily through direct action of refluxed pepsin from the stomach which can be "silent" in that it may not cause heart burn pains but chronic vocal cord inflammation, cough, and potentially vocal cord polyps
+    * some patients despite being on [[PPIs]] develop injury to the vocal folds in laryngopharyngeal reflux [[LPR]] primarily through direct action of refluxed pepsin from the stomach which can be "silent" in that it may not cause heart burn pains but chronic vocal cord inflammation, cough, and potentially vocal cord polyps
     * pepsin is produced by chief cells in the gastric glands of the stomach lining and is the main enzyme which breaks down protein in the stomach and is responsible for 10–15% of total protein hydrolysis,and works best around pH 1.5–2.5
     * studies show that across pH 2–6, adding pepsin consistently produced significantly more mucosal injury than acid treatment alone, indicating that pepsin extends the damaging range of reflux into “weakly acidic” conditions