Effect of fasting on laryngopharyngeal reflux disease in male subjects

To address the effect of fasting on laryngopharyngeal reflux disease (LPRD). A total of 22 male subjects have been recruited for this study. Subjects with vocal fold pathologies, recent history of upper respiratory tract infection or laryngeal manipulation were excluded. Demographic data included age and history of smoking. All subjects were evaluated while fasting for at least 12 h and non-fasting. By non-fasting we mean that they ate and drank during the day at their discretion with no reservation. The abstention from water and or food intake during the non-fasting period extended from few minutes to 3 h. All subjects were evaluated at the same time during the day. The evaluation consisted of a laryngeal examination and the Reflux Symptom Index (RSI). The Reflux Finding Score (RFS) was used to report on the reflux laryngeal findings. Subjects were considered to have LPRD if either the RSI or the RFS were positive (>9 RSI, >7 RFS). There was a non-significant increase in the total prevalence of LPRD while fasting compared to non-fasting (32 vs. 50 % while fasting, p value 0.361). In the RSI, the most common symptoms while non-fasting and fasting were throat clearing (64 vs. 68 %), postnasal drip (45 vs. 59 %) and globus sensation (36 vs. 50 %). The average score of all the three increased significantly while fasting. For the RFS the most common laryngeal findings in the non-fasting group versus the fasting group were erythema (77 vs. 68 %), thick endolaryngeal mucus (77 vs. 77 %) and posterior commissure hypertrophy (55 vs. 64 %). Fasting results in a nonsignificant increase in laryngopharyngeal reflux disease. The increase can be hypothetically explained on the change in eating habits and the known alterations in gastric secretions during Ramadan. Fasting subjects must be alert to the effect of LPRD on their throat and voice in particular.