Abstract
Introduction: Several findings suggest that there is an association between atypical symptoms such as coughing, laryngitis, and chest pain and the presence of gastro-esophageal reflux. However, the cause – effect relationship is still controversial. Methodology: Data from 348 patients with atypical symptoms (coughing, laryngitis, and chest pain) and suspicious GERD who underwent 24-hour esophageal impedance pH monitoring were collected retrospectively. Results: The prevalence of GERD in the studies performed was low with 58% of the cases being normal. Most patients were females. The primary symptom in the abnormal studies was laryngitis, followed by chest pain (49% and 38% respectively). 57% of these patients
exhibited non-acid reflux. Conclusion: The prevalence of gastro-esophageal reflux in patients with atypical manifestations is low. The most frequent finding in patients with abnormal results after impedance esophageal pH monitoring was non-acid reflux.
References
Richter J. Gastroesophageal reflux disease. Best Practice & Research Clinical Gastroenterology, Vol 21, No 4, pp. 609-631, 2007. https://doi.org/10.1016/j.bpg.2007.03.003
Vaezi MF. Laryngeal Manifestations of Gastroesophageal Reflux Disease. Current Gastroenterology Reports 2008; 10: 271-277 https://doi.org/10.1007/s11894-008-0055-2
Hicks DM, Ours TM, Abelson TI et al. The prevalence of hypopharynx findings associated with gastroesophageal reflux in normal volunteers. J voice 2002; 16: 554-579 https://doi.org/10.1016/S0892-1997(02)00132-7
Vaezi MF. The role of pH monitoring in extraoesophageal gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2006; 23 (Suppl 1): 40-49 https://doi.org/10.1111/j.1365-2036.2006.02797.x
Tutuian R., Castell D. Gastroesophageal reflux monitoring: ph and impedance. GI Motility online 2006 doi: 10.1038/gimo31.
Kahrilas P. Gastroesophageal reflux disease. N Engl J Med 2008; 359: 1700-1707. https://doi.org/10.1056/NEJMcp0804684
Modlin I., Moss S. Symptom Evaluation in Gastroesophageal reflux disease. J Clin Gastroeneterology 2008; 42: 558-563. https://doi.org/10.1097/MCG.0b013e31816207cb
Moore J., Vaezi M. Extraesophageal manifestations of gastroesophageal reflux disease: real or imagined? Current Opinion in Gastroenetrology 2010, 26: 389-394
https://doi.org/10.1097/MOG.0b013e32833adc8d
Malhotra A, Freston JW, and Aziz K. Use of pH - Impedance Testing to Evaluate Patients With Suspect Extraesophageal Manifestations of Gastroesophageal Reflux Disease. J Clin Gastroenterol 2008; 42: 271-278. https://doi.org/10.1097/MCG.0b013e31802b64f3
Belafsky PC, Postma GN, Koufman JA. Laryngopharyngeal reflux symptoms improve before changes in physical findings. Laryngoscope 2001; 111 (6): 979-981 https://doi.org/10.1097/00005537-200106000-00009
Vaezi MF. Gastroesophageal reflux-related chronic laryngitis: con. Arch Otolaryngol Head Neck Surg 2010; 136(9): 914-915."https://doi.org/10.1001/archoto.2010.145