Symposium: Gastroesophageal Reflux DiseaseExtraesophageal Manifestations of GERD
Section snippets
Epidemiology
Asthma is a prevalent condition affecting 5 to 10% of the world's population,6 and its incidence has been increasing worldwide over the past several decades.7 Accumulated epidemiologic evidence has clearly established an association between GERD and asthma, and some evidence supports a causative role, adding GERD to the list of important triggers in asthma.
Epidemiology
Chronic cough, defined as the persistence of cough for more than 3 to 8 weeks,60 is among the leading symptoms for which medical attention is sought and accounts for 30 million physician visits per year.60 For at least 3 decades, GERD has been recognized as an important contributor to chronic cough. Multiple studies have identified GERD as among the 3 most common causes of chronic cough in all age groups60 contributing to cough in up to 40% of cases.61
In 1981, Irwin et al62 prospectively studied
Other Pulmonary Diseases and GERD
Whereas asthma and chronic cough are the most widely studied of the pulmonary disorders associated with GERD, there is a large and growing list of claimed pulmonary-GERD associations (see Table 1).
Epidemiology
Although many ear, nose, and throat (ENT) conditions have been associated with GERD, the most predominant ENT manifestation of EER is probably laryngitis. Because of the various descriptions of the inflamed larynx, and proposed mechanisms of injury, GERD-related laryngitis has gone by many different names, including posterior laryngitis, acid laryngitis, peptic laryngitis, and the currently favored term, reflux laryngitis. Although the prevalence of reflux laryngitis is unknown, it is estimated
Other Otolaryngeal Diseases and GERD
Laryngeal injury (such as inflammation, edema, contact ulcer formation, and contact granuloma formation) and laryngeal symptoms (such as hoarseness and globus) are the most studied of the otolaryngeal disorders associated with GERD. However, there is a large and growing list of claimed otolaryngeal disease associations with GERD (see Table 1). Interest in the association between several diseases such as subglottic stensosis,113 vasomotor rhinitis,114 and laryngospasm115 has arisen.
Yellen et al
Conclusions
Extraesophageal associations with GERD include common illnesses and complaints such as asthma, chronic cough, laryngitis, and many others. Although EERs are a heterogeneous group of disorders, some general characterizations can be made.
Many patients with EER do not have classic symptoms of GERD, such as heartburn and regurgitation. Owing partly to the high prevalence of “silent GERD” in this population, diagnosing EER can be difficult. Traditional tests, such as endoscopy and barium esophagram,
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Cited by (63)
Esophageal Disorders
2020, Dysphagia: Clinical Management in Adults and ChildrenConfounders of severe asthma: Diagnoses to consider when asthma symptoms persist despite optimal therapy
2018, World Allergy Organization JournalCitation Excerpt :Gastroesophageal Reflux Disease (GERD) is a common cause of respiratory symptoms in adults. Generally, GERD is associated with post nasal-drip and often presents as a chronic cough (upper-airway cough syndrome) with chest tightness that is usually not associated with airway obstruction [44]. When it masquerades as asthma, additional symptoms such as heartburn and regurgitation may be present.
Esophageal Disorders
2015, Dysphagia: Clinical Management in Adults and ChildrenReflux and Acid Peptic Diseases in the Elderly
2014, Clinics in Geriatric MedicineCitation Excerpt :Atypical symptoms include dyspepsia, epigastric pain, nausea, bloating, and belching, which may indicate GERD but may overlap with other conditions.1 Extraesophageal manifestations of reflux include asthma, chronic cough, and laryngitis.1,34–36 In this setting, GERD symptoms must be differentiated from those related to gastric disorders (eg, peptic ulcer disease), infectious and motor disorders of the esophagus, and hepatobiliary disorders.37
Extraesophageal Manifestations of Gastroesophageal Reflux Disease
2013, Gastroenterology Clinics of North AmericaCitation Excerpt :In 2006, the modified Delphi process was used to define GERD as “a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications.”1 Historically, GERD is defined as primary complaints of heartburn and regurgitation1–4; however, it is now recognized that a range of extraesophageal symptoms may be its sole or accompanying manifestation. For example, chronic cough, asthma, posterior laryngitis, and dental erosion are but a few extraesophageal manifestations of GERD (Fig. 1).1,5