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Updated: Oct 28, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Non-acid reflux and reflux laryngitis: new perspectives on mechanism, diagnosis and treatment
Hongshan Chang1, Rui Sun1, Huan Qiu2
1First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.
Abstract:
Non-acid reflux may serve as a potential contributing factor in the pathogenesis of reflux pharyngitis. Its plausible injury-related mechanisms may partly explain difficult-to-treat clinical presentations and contribute to diagnostic and therapeutic challenges, with consequent impacts on patients' quality of life. Recently, the potentially significant role of non-acid reflux in refractory reflux pharyngitis has emerged as a prominent topic in this field, unveiling a novel pathophysiological mechanism that transcends the traditional gastric acid damage model. This underlying mechanism encompasses the independent and synergistic damaging effects of various active components, including bile acids, pancreatic enzymes, pepsin and gas reflux. It involves multiple pathways, such as intracellular reactivation, disruption of tight junctions, inflammatory cascade responses, and hypoxic injury. This article provides a narrative review discussing potential roles of non-acid reflux in the pathogenesis of reflux pharyngitis, focusing on elucidating the pathogenic mechanisms associated with each component of non-acid reflux, the advancements and limitations of current diagnostic techniques, and comprehensive intervention strategies. This review may hold potential clinical translational value for optimizing the hierarchical management of reflux pharyngitis and alleviating the symptom burden in refractory patients.
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