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Les manifestations supraglottiques du reflux gastro-œsophagien

The supraglottic manifestations of gastroesophageal reflux disease

  • Published:
Acta Endoscopica

Résumé

Les manifestations supraglottiques du reflux (RGOSG) ont ouvert au gastro-entérologue un nouveau domaine de pratique clinique et d’investigations. Jusqu’à présent la majorité des publications concernées le furent dans des revues de pneumologie, d’oto-rhino-laryngologie et de stomatologie.

Les signes d’œsophagite et les symptômes classiques de RGO manquent dans environ la moitié des cas. La faible sensibilité de l’endoscopic a promu la pH-métrie/24 heures au rang de «gold standard» du diagnostic. Pour des motifs techniques, un traitement d’épreuve par IPP (durée environ 3 mois) a été préféré et inclus dans un algorithme applicable à chaque catégorie de manifestations du RGOSG. A l’avenir, une coopération interdisciplinaire et intégrée devrait permettre une gestion adéquate de cette pathologie complexe.

Summary

The supraglottic gastroesophageal reflux (SGGER) has opened to the gastroenterologist a new field in clinical practice and for adapted investigations. Until now, most of the studies were published in pulmonary, ENT, and orodental journals. The present review gives an overview of calling symptoms and lesions observed in the injured organs with guidelines useful for an appropriate management.

Signs of esophagitis and classical symptoms of GERD are absent in about half of the patients with SGGER, a reason why such a pathology has been missed for such a long time. The low sensitiveness of endoscopy has promoted the 24 hours pH metry as the « gold standard » of the diagnosis. In current practice, for technical constraints, a PPI empiric treatment (duration around 3 months) has been preferred as the first step on an algorithm for any type of SGGER. A call for an interdisciplinary workgroup is proposed as a challenge in this type of intricated pathologies.

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    P. Mainguet

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Mainguet, P. Les manifestations supraglottiques du reflux gastro-œsophagien. Acta Endosc 34, 311–325 (2004). https://doi.org/10.1007/BF03004260

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