Approach to the patient with presumed extraoesophageal GERD

Abstract Reflux related cough, asthma and laryngitis are frequently encountered and are considered part of extraoesophageal syndromes. The diagnosis of extraoesophageal reflux is difficult due to the lack of gold standard diagnostic criteria. Esophagogastroduodenoscopy and esophageal pH monitoring a...

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Bibliographic Details
Published in:Baillière's best practice & research. Clinical gastroenterology 2013-06, Vol.27 (3), p.415-431
Main Authors: Ates, Fehmi, MD, Vaezi, Michael F., MD, PhD, MSc (Epi)
Format: Article
Language:English
Subjects:
Asthma
Asthma - diagnosis
Catheters
Chronic cough
Chronic laryngitis
Cough - diagnosis
Ear diseases
Endoscopy, Digestive System
Esophageal pH Monitoring - adverse effects
Esophagus
Extraoesophageal reflux syndrome
Gastroenterology and Hepatology
Gastroesophageal Reflux - diagnosis
Gastroesophageal Reflux - drug therapy
Health care
Humans
Laryngitis - diagnosis
Larynx
Pain
Patients
Proton Pump Inhibitors - therapeutic use
Reflux
Studies
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Summary:Abstract Reflux related cough, asthma and laryngitis are frequently encountered and are considered part of extraoesophageal syndromes. The diagnosis of extraoesophageal reflux is difficult due to the lack of gold standard diagnostic criteria. Esophagogastroduodenoscopy and esophageal pH monitoring are inadequate diagnostic tools for due to poor sensitivity and specificity. For this reason, empirical PPI therapy is recommended as an initial approach to diagnose and treat the potential underlying cause of these symptoms in patients without alarm symptoms. Diagnostic testing with esophageal pH and/or impedance monitoring and esophageal motility testing is usually reserved for those who continue to be symptomatic despite a trial of therapy with PPIs. Recent developments have increased our understanding of this difficult to treat group of patients but more research into reflux related extraoesophageal symptoms are needed to better diagnose and treat this group.
ISSN:1521-6918
1532-1916
DOI:10.1016/j.bpg.2013.06.009