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Bile-induced laryngitis: is there a basis in evidence?
Clarence T Sasaki1, James Marotta, Jagdeep Hundal
1Section of Otolaryngology, Department of Pathology, Yale School of Medicine, New Haven, Connecticut 06520-8041, USA.
The Annals of Otology, Rhinology, and Laryngology
|April 14, 2005
Summary
Bile reflux components, taurocholic acid and chenodeoxycholic acid, cause significant laryngeal mucosa inflammation. This suggests bile reflux, not just acid reflux, contributes to laryngeal injury.
Area of Science:
- Gastroenterology
- Otolaryngology
- Pathology
Background:
- Bile reflux is common and may synergize with acid reflux to damage esophageal tissue.
- The risk of laryngeal mucosa damage from bile reflux remains unclear.
Purpose of the Study:
- To investigate the direct impact of bile components on laryngeal mucosa inflammation.
- To determine if bile reflux contributes to laryngeal injury independently of gastric acid.
Main Methods:
- A rat model (n=40) was used, applying taurocholic acid and chenodeoxycholic acid to laryngeal mucosa at different pH levels.
- Histological analysis by a blinded pathologist assessed inflammation scores.
Main Results:
- Taurocholic acid at acidic pH and chenodeoxycholic acid at basic pH significantly increased laryngeal inflammation scores compared to saline control.
- Inflammation levels approached or exceeded those caused by hydrochloric acid at pH 1.2.
Conclusions:
- Bile components can directly injure laryngeal mucosa, contributing to laryngeal damage.
- These findings may explain why acid suppression alone is insufficient for some laryngeal injuries and support alternative protective strategies.