Extraesophageal Manifestation of Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is defined by the Montreal Consensus as “a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications.” The Brazilian Consensus is more precise and acknowledges the plethora of GERD symptoms defining GERD as “a chronic disorder related to the retrograde flow of gastro-duodenal contents into the esophagus and/or adjacent organs, resulting in a spectrum of symptoms, with or without tissue damage.” This make clear that GERD has a myriad of clinical presentations encompassing esophageal and extraesophageal symptoms making the diagnosis of the disease difficult in some cases. Virtually all adjacent organs to the esophagus may be affected by the gastric contents and new discoveries are made on a regular basis showing that even distant organs may be affected by GERD as well. Extraesophageal presentations can have multifactorial, often non-GERD, causes, and causality between reflux and these clinical entities is sometimes difficult to prove.
KeywordsEsophageal manometry Ambulatory pH monitoring Cough Microaspiration Hoarseness Pulmonary fibrosis
- 7.Iovino P, Pascariello A, Limongelli P, Tremolaterra F, Consalvo D, Sabbatini F, Amato G, Ciacci C. The prevalence of sexual behavior disorders in patients with treated and untreated gastroesophageal reflux disease. Surg Endosc. 2007;21:1104–10. Epub 2007 Mar 13. This study analyzed sexual manifestation in patients with GERD compared to healthy volunteers.PubMedCrossRefGoogle Scholar
- 8.Jobe BA, Richter JE, Hoppo T, Peters JH, Bell R, Dengler WC, DeVault K, Fass R, Gyawali CP, Kahrilas PJ, Lacy BE, Pandolfino JE, Patti MG, Swanstrom LL, Kurian AA, Vela MF, Vaezi M, DeMeester TR. Preoperative diagnostic workup before antireflux surgery: an evidence and experience-based consensus of the Esophageal Diagnostic Advisory Panel. J Am Coll Surg. 2013;217:586–97. doi: 10.1016/j.jamcollsurg.2013.05.023. Epub 2013 Aug 21. A consensus from experts from the field on diagnostic workup for GERD.PubMedCrossRefGoogle Scholar
- 11.Marsicano JA, de Moura-Grec PG, Bonato RC, Sales-Peres Mde C, Sales-Peres A, Sales-Peres SH. Gastroesophageal reflux, dental erosion, and halitosis in epidemiological surveys: a systematic review. Eur J Gastroenterol Hepatol. 2013;25:135–41. A systematic review showing controversies in the association of GERD and halitosis, but a significant number of publications pointing to a casual effect.PubMedCrossRefGoogle Scholar
- 12.Mizyed I, Fass SS, Fass R. Review article: gastro-oesophageal reflux disease and psychological comorbidity. Aliment Pharmacol Ther. 2009;29:351–8. doi: 10.1111/j.1365-2036.2008.03883.x. Epub 2008 Nov 8. A systematic review on the association of GERD and psychologic/psychiatric manifestations.PubMedCrossRefGoogle Scholar
- 13.Neto SC, Herbella FA, Silva LC, Patti MG. Ratio between proximal/distal gastroesophageal reflux does not discriminate abnormal proximal reflux. World J Surg. 2014;38(4):890–6. doi: 10.1007/s00268-013-2341-x.
- 15.Pearson JP, Parikh S, Orlando RC, Johnston N, Allen J, Tinling SP, Johnston N, Belafsky P, Arevalo LF, Sharma N, Castell DO, Fox M, Harding SM, Morice AH, Watson MG, Shields MD, Bateman N, McCallion WA, van Wijk MP, Wenzl TG, Karkos PD, Belafsky PC. Review article: reflux and its consequence--he laryngeal, pulmonary and oesophageal manifestations. Conference held in conjunction with the 9th International Symposium on Human Pepsin (ISHP) Kingston-upon-Hull, UK, 21-23 April 2010. Aliment Pharmacol Ther. 2011;33 Suppl 1:1–71. A series of 11 articles dealing with the pathophysiology of GERD and extra-esophageal manifestation.Google Scholar