Korean J Med.  2010 Feb;78(2):145-154.

Diagnosis of gastroesophageal reflux disease: Esophageal and extraesophageal manifestations

• Lee BE
• Kim GH

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.

Keyword

Gastroesophageal reflux disease; Esophageal manifestation; Extraesophageal manifestation

MeSH Terms

Asthma
Bronchial Spasm
Chest Pain
Cough
Diagnostic Tests, Routine
Endoscopy
Gastroesophageal Reflux
Heartburn
Hoarseness
Humans
Hydrogen-Ion Concentration
Laryngismus
Laryngitis
Larynx
Pharynx
Proton Pumps
Proton Pumps