Diagnosis and management of supra-esophageal complications of reflux disease

Supra-esophageal reflux disease may be manifested in numerous ways, including reflux laryngitis, chronic cough, chronic sinusitis, and dental enamel loss. The mechanisms of pharyngeal and laryngeal reflux are not clearly defined, and standard reflux testing does not consistently demonstrate supra-es...

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Bibliographic Details
Published in:Current gastroenterology reports 2000-06, Vol.2 (3), p.210-216
Main Authors: Nostrant, T T, Rabine, J C
Format: Article
Language:English
Subjects:
Algorithms
Anti-Ulcer Agents - therapeutic use
Chronic Disease
Cough - etiology
Endoscopy, Gastrointestinal
Gastroesophageal Reflux - complications
Gastroesophageal Reflux - prevention & control
Humans
Hydrogen-Ion Concentration
Laryngitis - etiology
Laryngoscopy
Monitoring, Physiologic
Sinusitis - etiology
Tooth Erosion - etiology
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Summary:Supra-esophageal reflux disease may be manifested in numerous ways, including reflux laryngitis, chronic cough, chronic sinusitis, and dental enamel loss. The mechanisms of pharyngeal and laryngeal reflux are not clearly defined, and standard reflux testing does not consistently demonstrate supra-esophageal reflux. The diagnosis is usually based on clinical suspicion when other causes of symptoms are not found and on the patient's response to empiric acid suppression. With the development of triple-probe pH monitoring, through which pharyngeal pH can be assessed along with esophageal pH, the physician may now be able to demonstrate pharyngeal reflux in relation to patient symptoms. Therapy consists primarily of behavioral modification and aggressive acid suppression, although some alternative therapies exist.
ISSN:1522-8037
1534-312X
DOI:10.1007/s11894-000-0063-3