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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gastroesophageal reflux disease (GERD) is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus; heartburn, its most common manifestation, occurs in 7% to 10% of the U.S. population on a daily basis. In addition, many so-called extraesophageal or atypical symptoms, including chronic cough, laryngitis and other otolaryngologic conditions, asthma, and unexplained chest pain, can be associated with GERD, but these patients appear to have a decreased frequency of heartburn, making the diagnosis of GERD difficult. All patients can be successfully managed with appropriate, titrated use of pharmacologic therapy. Antireflux surgery should thus be considered as an option only for patients who cannot afford or choose not to continue long-term medical therapy and for the rare patient with side effects or resistance to proton pump inhibitors. Endoscopic therapy for reflex should be considered as an experimental technology needing continuing evaluation.
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PMID:Gastroesophageal reflux disease--state of the art. 1212 Jan 80

The discomfort caused by persistent cough compels a great number of patients to seek medical aid. Persistent cough interferes with the patient's sleep, professional and social activities. The pathogenic triad of asthma, post nasal drip syndrome and gastroesophageal reflux disease, alone or in combination, is responsible for the majority of cases of chronic cough. Investigation of chronic cough, according to a rational protocol leads to the identification of the cause for chronic cough in approximately 90% of the cases.
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PMID:[Chronic cough]. 1218 56

Both GERD(gastroesophageal reflux disease) and chronic respiratory disease are common disease in old and the association between GERD and chronic respiratory disease are recently proved in many reports. Patient with GERD have a higher prevalence of asthma and chronic cough. Aggressive antireflux therapy in patient with asthma and GERD results in improvement in asthma outcome. In our study, endoscopic examination revealed that the prevalence of esophageal mucosal disease in patient with asthma was about 83%. In this paper, I review the role of GERD in chronic respiratory disease, especially asthma.
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PMID:[Chronic respiratory disease and gastroesophageal reflux]. 1218 57

Gastro-oesophageal reflux is a common clinical disorder associated with a variety of respiratory symptoms, including chronic cough and exacerbation of asthma. In this study, the potential role of acid-induced tachykinin release was examined in guinea pigs and rabbits, by examining the effects of the tachykinin NK1 and NK3 receptors antagonists (SR 140333 and SR 142801, respectively) (1-10 mg x kg(-1)) on plasma protein extravasation induced in airways by hydrochloric acid (HCl) infusion in the oesophagus. Guinea pigs were anaesthetised with urethane, while rabbits were subject to neuroleptoanalgesia with hypnorm. Airway vascular leakage was evaluated by measuring extravasation of Evans blue dye. All animals were pretreated with atropine (1 mg x kg(-1) i.p.), propranolol (1 mg x kg(-1) i.p.), phosphoramidon (2.5 mg x kg(-1) i.v.) and saline or tachykinin receptor antagonists (1-10 mg x kg(-1) i.p.). Infusion of 1 N HCl into the oesophagus led to a three- and five-fold increase in plasma extravasation in the main bronchi and trachea, respectively. This increase was largely prevented by the tachykinin NK1 and NK3 receptor antagonists SR 140333 and SR 142801 (1-10 mg x kg(-1)). These results suggest that protein extravasation in the airways, as induced by intraoesophageal HCl infusion, is mainly dependent on the release of tachykinins, and that both NK1 and NK3 tachykinin receptors are involved. The results suggest that HCl-induced sensory nerve stimulation may act in the periphery on intermediate neurons and/or ganglia where NK3 receptors have been shown to play an important role.
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PMID:Tachykinins and airway microvascular leakage induced by HCl intra-oesophageal instillation. 1221 54

Diabetes mellitus and cystic fibrosis (CF) have been reported before in the literature, but they have never been reported in the same patient in the Middle East. We present the first reported case of insulin dependent diabetes mellitus (IDDM) and CF in 2 siblings of the same family. Both siblings were diagnosed early in life with IDDM, and their diabetes was well controlled on insulin. Cystic fibrosis was diagnosed in the first case one year after IDDM was diagnosed due to history of chronic cough and in the 2nd case by family screening. Both had severe failure to thrive, recurrent chest infections and gastro-esophageal reflux. With treatment both showed clinical improvement, but continued to have moderate lung disease radiologically and by pulmonary function test.
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PMID:Diabetes mellitus and cystic fibrosis in 2 Saudi siblings. 1251 10

Acid reflux--most often associated with heartburn--may also cause a wide range of laryngopharyngeal symptoms, including laryngitis and chronic cough. Symptoms of laryngopharyngeal reflux (LPR), like those of gastrooesophageal reflux disease, result from abnormal exposure of tissues to acid refluxate. Deranged sensorimotor function of the upper oesophageal sphincter appears to play a key role in the aetiology of LPR, but the disease is not completely understood. Among the significant long-term complications of LPR are bronchopulmonary disorders, recurrent pneumonia, chronic cough, chronic or recurrent laryngitis, and oral cavity disorders. It also appears to be a risk factor for the development of laryngeal carcinoma. Diagnosis of LPR is based on physical examination, medical history, and results of specific tests. At present, the test of choice for LPR diagnosis is intraluminal oesophageal pH monitoring. Barium contrast oesophagography, intraoesophageal acid perfusion challenge, and flexible endoscopic evaluation of swallowing with sensory testing may also be used in LPR diagnosis. Treatment for LPR includes changes to the diet and lifestyle, and acid-suppressing therapy. The Therapeutic Working Party at the First Multi-Disciplinary International Symposium on Supraesophageal Complications of Gastroesophageal Reflux Disease has recommended twice-daily dosing with a proton pump inhibitor as an initial therapy for LPR, with treatment continued between 4 weeks and 6 months. Such treatment has been found highly effective in resolving symptoms of LPR, and it may also prevent the serious long-term complications of this condition.
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PMID:Laryngopharyngeal manifestations of reflux: diagnosis and therapy. 1257 26

In adults, an estimated 4% to 10% of chronic, nonspecific laryngeal disease seen in otolaryngologic clinics is associated with gastroesophageal reflux disease (GERD). Although no such estimates exist in children, many investigators have reported extraesophageal manifestations of GERD, of which the most common is the association of GERD with asthma and chronic cough. A variety of signs and symptoms of otolaryngologic disease also have been attributed to GERD, including hoarseness, laryngitis, chronic rhinitis, sinusitis, globus pharyngeus, recurrent croup, laryngomalacia, stridor, subglottic stenosis, otalgia, vocal cord granulomas, and oropharyngeal dysphagia. However, proof of the association between these manifestations of otolaryngologic disease and GERD is sparse. Furthermore, the manifestations of otolaryngologic disease often occur in the absence of such classic systems of GERD as heartburn or chest pain. This review explores the role of GERD in otolaryngologic disease in children.
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PMID:Pediatric otolaryngologic manifestations of gastroesophageal reflux disease. 1273 48

OBJECTIVE: To report 21 yrs of experience with pediatric flexible fiberoptic bronchoscopy in infants and children, explore newer applications, delineate potential complications, and make recommendations for its future application. DESIGN: Retrospective review. SETTING: A 20-bed pediatric critical care unit in a tertiary care, university-based children's hospital. PATIENTS: A total of 2,836 pediatric and infant fiberoptic bronchoscopies, performed over a course of 21 yrs, were reviewed. Measurement and MAIN RESULTS: A total of 2,836 children (1,536 girls) were subjected to flexible fiberoptic bronchoscopy. Of those, laryngeal mask airway was incorporated in 92 procedures (3.2%) and general anesthesia was applied in 198 cases (7%). The youngest subject was a 1-wk-old, 600-g, premature infant. The procedure resulted in diagnoses that modified patient care, particularly in tracheostomized infants and those with upper airway obstruction, plastic bronchitis of acute chest syndrome, dyskinetic cilia syndrome, immunocompromised individuals, and those with unexplained chronic cough and recurrent pulmonary infiltrates. Microbiologic and cytologic data from bronchoalveolar lavage helped confirm the diagnoses of pulmonary hemosiderosis and gastroesophageal reflux and validated the presence, or lack of, bacterial or viral pathogens. A total of 21 patients (<1%) experienced life-threatening hypoxemia, prompting termination of the procedure. Laryngospasm or bronchospasm was observed in 17 individuals (<1%) undergoing bronchoalveolar lavage, and 4% of the total population experienced mild nasopharyngeal bleeding. No fatalities were encountered. CONCLUSIONS: Pediatric flexible fiberoptic bronchoscopy is a safe diagnostic and interventional tool, even in young or extremely premature infants. Although the rate of serious complications in this report is low, general anesthetic agents and incorporation of laryngeal mask airway is advocated for severe mucoid impaction, transbronchial biopsy, and chronic pulmonary infiltrates, which may necessitate extensive bronchoalveolar lavage.
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PMID:Pediatric fiberoptic bronchoscopy: Clinical experience with 2,836 bronchoscopies. 1278 Sep 89

Eosinophilic bronchitis is a recently described condition in patients with chronic cough, sputum eosinophilia, normal spirometry and no evidence of bronchial hyperreactivity. The aim of the study was to assess the causes of chronic cough and to identify the prevalence of eosinophilic bronchitis as a cause of chronic cough. Thirty-six patients [mean age 45.4 +/- 14.3 years (range 16-69 years), M/F: 4/32] with an isolated chronic cough lasting for more than 4 weeks were recruited from the outpatient clinic. In all patients, after a full history and physical examination, blood eosinophil count, eosinophilic cationic protein (ECP), serum total and specific IgE levels were measured. Spirometry, methacholine provocation test, skin prick tests, ear, nose and throat examination, induction of sputum and esophageal pH testing were performed. The mean duration of cough was 31.3 +/- 52.3 months. Sputum eosinophilia greater than 3% was present in 12 (33.3%) patients and they were diagnosed as eosinophilic bronchitis. Their induced sputum had a mean eosinophil count of 8.3% and a mean ECP level of 98.5 mg x l(-1), which were higher than the others (P=0.003, both). The diagnosis of the remaining patients were postnasal drip syndrome in eight, gastroesophageal reflux disease in eight, post-infectious cough in two and cough-variant asthma in one patient. In conclusion, eosinophilic bronchitis is an important cause of chronic cough and should be considered in the assessment of patients before regarding them as having idiopathic chronic cough.
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PMID:Eosinophilic bronchitis as a cause of chronic cough. 1281 57

Reflux disease (GERD) and chronic cough often coexist, but a temporal correlation using the symptom association probability has not been reported. Our aim was to determine if a temporal correlation exists between cough and GERD. Sixty-one patients with chronic cough had esophageal pH monitoring with sensors 5 and 20 cm above the LES. The symptom (SI) and symptom sensitivity (SSI) indices and the symptom association probability (SAP) were used to test cough-reflux association. Pathological reflux was defined as the percentage of time pH < 4 exceeded 4.2%. A significant temporal association between cough and distal reflux was made in 35% of patients by SAP compared with only 14.8% by SI and SSI alone (P < 0.002). Patients with pathologic reflux had a greater likelihood of a temporal symptom correlation (57.1%) when not on acid-blocking medications. In conclusion, a temporal association between cough and distal reflux exists in one third of patients, especially those with pathological reflux. The SAP is a more sensitive measure of temporal association than SI or SSI.
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PMID:Temporal correlation between chronic cough and gastroesophageal reflux disease. 1282 61


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