Saliva Test for Laryngopharyngeal Reflux (LPR)

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.)

One test company is rdbiomed using their Peptest kit. This test is not yet available in the United States per company representative (7/18/12).

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.

Extremely Discounted Blood Tests for Cash-Paying or Uninsured Patients

Through the cooperation of Summit County Medical Society, LabCorp, and PrePaidLab, patients are now able to get lab tests done for a small fraction of the normal cost via the medial society website. Anyone near a LabCorp location nationwide is able to use this website to obtain the same low-cost blood tests.

For example, a lipid panel (cholesterol test) can cost as much as $148 for an uninsured person. The same test is available for less than $18 through the site.

Here are the steps to take:
1) Click here and choose the tests your doctor says you need.
2) Give the doctor's fax number, pay with a credit card, and print out the order.
3) Take the order to any LabCorp location in 47 states and have the work done.
4) Results are sent securely to the patient and the doctor, often within 24 hours.

Sound too good to be true? It really is true.

Read about this amazing offer on a news report from CNN here.

Cheap Quality Prescriptions Thru Costco Pharmacy Mail Order

A patient recently brought this to my attention... but Costco Pharmacy offers very good prices on drugs, especially generics, even if a patient has no health insurance. Furthermore, you do NOT have to be a member to purchase these drugs! Even more importantly, the medications can be considered "good" unlike medications purchased from other online sources from Canada or Mexico.

For example, I searched for these drugs on 11/27/09 and these are the prices that came up:

Allegra 180mg
$79.19 for 30 (Brand Name)
$36.18 for 30 (generic)

Prilosec 20mg
$158.13 for 30 (Brand Name)
$15.18 for 30 (generic)

Flonase
$87.36 for 1 (Brand Name)
$15.28 for 1 (generic)

Of course, with insurance, these prices may be even cheaper!

Check it out here. Click on pharmacy at the top and than look for the "Prescription Price Checker" link.