Korean J Med.  2016 Dec;91(3):257-263. 10.3904/kjm.2016.91.3.257.

Extraesophageal Manifestations of Gastroesophageal Reflux Disease

• Nam SJ
• Park SC
• Lee SJ

• KMID: 2361429
• DOI: http://doi.org/10.3904/kjm.2016.91.3.257

Abstract

Gastroesophageal reflux disease (GERD) is prevalent in Korea. Clinical manifestations include typical symptoms which are heartburn and regurgitation and atypical symptoms that can be esophageal or extraesophageal. Various extraesophageal manifestations are associated with GERD, and the most significant of these are chronic cough, laryngitis, and asthma. The diagnosis of extraesophageal syndrome is often difficult due to the poor sensitivity and specificity of available diagnostic modalities, including endoscopy, pH monitoring, and laryngoscopy. Consequently, empirical treatment with a proton pump inhibitor (PPI) is considered to be the most cost-effective tool for the diagnosis and management of patients suspected of having extraesophageal syndrome without alarm features. Those who do not respond to PPI therapy should undergo an additional work-up that includes monitoring esophageal pH or impedance, and motility tests to evaluate the relationship between reflux and symptoms. Surgical management should cautiously be considered for very carefully selected patients.

Keyword

Gastroesophageal reflux; Extraesophageal manifestation; Cough; Laryngitis; Asthma

MeSH Terms

Asthma
Cough
Diagnosis
Electric Impedance
Endoscopy
Gastroesophageal Reflux*
Heartburn
Humans
Hydrogen-Ion Concentration
Korea
Laryngitis
Laryngoscopy
Proton Pumps
Sensitivity and Specificity
Proton Pumps