Diagnosis of gastroesophageal reflux disease: Esophageal and extraesophageal manifestations.
- Author:
Bong Eun LEE
1
;
Gwang Ha KIM
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
- Publication Type:Review
- Keywords:
Gastroesophageal reflux disease;
Esophageal manifestation;
Extraesophageal manifestation
- MeSH:
Asthma;
Bronchial Spasm;
Chest Pain;
Cough;
Diagnostic Tests, Routine;
Endoscopy;
Gastroesophageal Reflux;
Heartburn;
Hoarseness;
Humans;
Hydrogen-Ion Concentration;
Laryngismus;
Laryngitis;
Larynx;
Pharynx;
Proton Pumps
- From:Korean Journal of Medicine
2010;78(2):145-154
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The manifestations of gastroesophageal reflux disease (GERD) have been classified into either esophageal or extraesophageal symptoms. Esophageal manifestations include classic symptoms of reflux, such as heartburn and regurgitation, and atypical noncardiac chest pain. Laryngitis, chronic cough, hoarseness, asthma or dental erosion are classified as extraesophageal symptoms, and they have a common pathophysiology, including microaspiration of gastric content into the larynx and pharynx, and vagally mediated bronchospasm and laryngospasm. In extraesophageal GERD, patients usually do not display the classic symptoms, so it is difficult to confirm the diagnosis of GERD. Endoscopy and pH monitoring have proved to have poor sensitivity and therefore are often not diagnostically helpful. Recently, anti-secretory therapy by proton pump inhibitor (PPI) is thought to be well-established, cost-effective tool and it is broadly used as both a diagnostic trial and as a therapeutic management. Diagnostic testing, such as pH monitoring, may be useful in those with partial or poor response to the initial treatment with PPI.
