Extra-esophageal manifestations of gerd: Who responds to GERD therapy?

被引：29

作者：

Naik R.D. ^{[1
]}

Vaezi M.F. ^{[1
]}

机构：

[1] Division of Gastroenterology, Hepatology, and Nutrition, Center for Swallowing and Esophageal Disorders, Vanderbilt University Medical Center, Nashville, TN 37232-5280

来源：

Current Gastroenterology Reports | 2013年 / 15卷 / 4期

关键词：

Asthma; Chronic laryngitis; Cough; Dental erosions; Extra-esophageal reflux; Fundoplication; Non-cardiac chest pain; PH monitoring;

D O I：

10.1007/s11894-013-0318-4

中图分类号：

学科分类号：

摘要：

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 extraesophageal signs and symptoms and continued PPI therapy in this group is not recommended. © 2013 Springer Science+Business Media New York.

引用

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