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Extra-esophageal manifestations of GERD: who responds to GERD therapy?
Curr Gastroenterol Rep. 2013 Apr; 15(4):318.CG

Abstract

Gastroesophageal reflux disease (GERD) is a common disease that is defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms. In addition to the esophageal manifestations of heartburn and regurgitation, the role of GERD in causing extra-esophageal symptoms, such as laryngitis, asthma, cough, chest pain, and dental erosions, is increasingly recognized with renewed interest. Due to the poor sensitivity of endoscopy and pH monitoring, and the poor specificity of laryngoscopy, empiric therapy with proton pump inhibitors (PPI) is now considered the initial diagnostic step in patients suspected of having GERD-related symptoms. In those who are unresponsive to such therapy, other diagnostic testing such as impedance/pH monitoring may be reasonable in order to exclude continued acid or weakly acid reflux. Recent data suggest that patients with extra-esophageal symptoms who have concomitant typical symptoms, moderate-sized hiatal hernia and moderate reflux on pH testing may respond better to acid suppressive therapy. This group only accounts for 20-30 % of patients commonly referred for suspected GERD. PPI-unresponsive patients usually have causes other than GERD for their extra-esophageal signs and symptoms and continued PPI therapy in this group is not recommended.

Authors+Show Affiliations

Division of Gastroenterology, Hepatology, and Nutrition, Center for Swallowing and Esophageal Disorders, Digestive Disease Center, Vanderbilt University Medical Center, Nashville, TN 37232-5280, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23435747

Citation

Naik, Rishi D., and Michael F. Vaezi. "Extra-esophageal Manifestations of GERD: Who Responds to GERD Therapy?" Current Gastroenterology Reports, vol. 15, no. 4, 2013, p. 318.
Naik RD, Vaezi MF. Extra-esophageal manifestations of GERD: who responds to GERD therapy? Curr Gastroenterol Rep. 2013;15(4):318.
Naik, R. D., & Vaezi, M. F. (2013). Extra-esophageal manifestations of GERD: who responds to GERD therapy? Current Gastroenterology Reports, 15(4), 318. https://doi.org/10.1007/s11894-013-0318-4
Naik RD, Vaezi MF. Extra-esophageal Manifestations of GERD: Who Responds to GERD Therapy. Curr Gastroenterol Rep. 2013;15(4):318. PubMed PMID: 23435747.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extra-esophageal manifestations of GERD: who responds to GERD therapy? AU - Naik,Rishi D, AU - Vaezi,Michael F, PY - 2013/2/26/entrez PY - 2013/2/26/pubmed PY - 2013/8/29/medline SP - 318 EP - 318 JF - Current gastroenterology reports JO - Curr Gastroenterol Rep VL - 15 IS - 4 N2 - Gastroesophageal reflux disease (GERD) is a common disease that is defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms. In addition to the esophageal manifestations of heartburn and regurgitation, the role of GERD in causing extra-esophageal symptoms, such as laryngitis, asthma, cough, chest pain, and dental erosions, is increasingly recognized with renewed interest. Due to the poor sensitivity of endoscopy and pH monitoring, and the poor specificity of laryngoscopy, empiric therapy with proton pump inhibitors (PPI) is now considered the initial diagnostic step in patients suspected of having GERD-related symptoms. In those who are unresponsive to such therapy, other diagnostic testing such as impedance/pH monitoring may be reasonable in order to exclude continued acid or weakly acid reflux. Recent data suggest that patients with extra-esophageal symptoms who have concomitant typical symptoms, moderate-sized hiatal hernia and moderate reflux on pH testing may respond better to acid suppressive therapy. This group only accounts for 20-30 % of patients commonly referred for suspected GERD. PPI-unresponsive patients usually have causes other than GERD for their extra-esophageal signs and symptoms and continued PPI therapy in this group is not recommended. SN - 1534-312X UR - https://www.unboundmedicine.com/medline/citation/23435747/Extra_esophageal_manifestations_of_GERD:_who_responds_to_GERD_therapy L2 - https://dx.doi.org/10.1007/s11894-013-0318-4 DB - PRIME DP - Unbound Medicine ER -