Various groups have been developing a fast, cheap, non-invasive saliva swab test to determine whether laryngopharyngeal reflux (LPR) is present or not. LPR may cause symptoms of:- Hoarseness
- Chronic (ongoing) cough
- Frequent throat clearing
- Constant mucus or phelgm in the throat
- Dry or sandpaper like sensation in the throat
- Pain or burning sensation in the throat
- Feeling of a lump in the throat (globus pharyngeus)
- Problems swallowing
- Bad/bitter taste in the mouth (especially in morning)
- Asthma-like symptoms
- Ear pain and/or persistent ear infections
- Post-nasal drip
- Large lingual tonsils
When you compare a spit test to the current way of how reflux is determined via barium swallow, upper endoscopy (EGD), and 24 hour ph/impedance testing, it sounds quite attractive.
How does such a test work?
It basically looks for a stomach protein called pepsin.
Given reflux is when stomach contents moves up towards the mouth and pepsin is a protein ONLY produced in the stomach... pepsin should NOT be found in the throat/mouth.
As such, the test can state yes or no whether LPR is present or not.
How good is the test?
Depending on the study, sensitivity ranges in the 80-100% (can actually detect reflux if truly present) and specificity is around 85% (truly no reflux if test is negative).
Unfortunately, such testing is not offered is most labs. (Currently working on getting such testing available in our office.)
References:
Sensitive pepsin immunoassay for detection of laryngopharyngeal reflux. Laryngoscope. 2005 Aug;115(8):1473-8.
Rapid salivary pepsin test: Blinded assessment of test performance in gastroesophageal reflux disease. Laryngoscope. 2012 Jun;122(6):1312-6. doi: 10.1002/lary.23252. Epub 2012 Mar 23.
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