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

Respiratory complications of gastroesophageal reflux disease that have been reported include hoarseness, wheezing, bronchospasm, stridor, laryngitis, and chronic cough. Syncope as a manifestation of gastroesophageal reflux disease-induced cough has not been described in the literature. We present an unusual case of gastroesophageal reflux that resulted in frequent cough-induced syncope. Treatment ultimately consisted of a laparoscopic Nissen fundoplication which resulted in sustained relief from both cough and syncope.
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PMID:Gastroesophageal reflux-induced cough syncope. 854 May 17

Gastro-oesophageal reflux (GOR) has been implicated in such clinical phenomena as aspiration pneumonia, bronchospasm or wheezing, apnea, stridor, and hoarseness. Various tests have been used as an aid to diagnosing patients with chronic respiratory disease where GOR is a causal factor. Different forms of conservative treatment have been tried for GOR, including cisapride. Several studies have evaluated its effect on the pH profile and respiratory symptoms in patients with chronic respiratory disease and have demonstrated improvement of nocturnal wheezing, cough, and irritability. Our experience with cisapride is positive in children with GOR. Patients refractory to medical treatment have been surgically treated with good results.
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PMID:Gastro-oesophageal reflux and chronic respiratory disease in infants and children: treatment with cisapride. 854 28

Gastroesophageal reflux disease is a chronic disease whose incidence is often underestimated. Approximately 10% of the population in the United States experience heartburn each day. In addition, as many as 50% of patients with unexplained chest pain, chronic hoarseness, or asthma may be suffering from gastroesophageal reflux disease. Disease severity ranges from occasional, mild heartburn to erosive esophagitis and its complications. Endoscopy and air-contrast barium radiography are important diagnostic tools. Esophageal pH monitoring can confirm excessive reflux in patients with atypical symptoms or in patients who do not respond to drug therapy. Depending on severity, gastroesophageal reflux disease may be managed through lifestyle modification, antacid and/or antirefluxant drugs, promotility (prokinetic) drugs, fundoplication, and/or acid-suppressant agents (eg, H2-receptor antagonists, proton pump inhibitors). Safety, effectiveness, patient compliance, and cost factors must be considered in determining the most appropriate long-term maintenance therapy.
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PMID:Gastroesophageal reflux disease. Current strategies for patient management. 876 11

There is a unique yet common relationship between gastroesophageal reflux (GER) and asthma. This paper's discussion covers the lower esophageal sphincter (LES) and other components that form the anti-reflux barrier and how the barrier can be breached. There are three predominant theories on the asthma/GER connection; (1) the inhalation of microaspirate into the lungs causes an inflammatory response, (2) a vagally mediated reflex pathway occurring when acid is present in the esophagus, and (3) a combination of the first two theories. Available diagnostic tests for GER include the "gold standard," the 24-hour ambulatory pH monitor. Adult asthmatic patients with GER can present with atypical symptoms such as worsening nocturnal asthma or hoarseness and not have a single classic symptom like heartburn. Treatment is implemented in a step-wise approach first using education to introduce conservative anti-reflux measures, progressing to pharmacotherapy (acid suppressive agents and promotility agents) and finally surgical correction like the Nissen fundoplication to create a competent anti-reflux barrier, thus achieving improved asthma management.
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PMID:Gastroesophageal reflux: a common exacerbating factor in adult asthma. 893 38

Laryngeal manifestation of gastroesophageal reflux is felt to be prevalent in our society. In general, diagnosis has been based primarily on symptoms. Historically, additional testing included laryngoscopy, barium swallow, manometry, and more recently, single- and double-probe pH monitoring. We evaluated 68 patients who were symptomatically suggestive of having reflux laryngitis. We administered surveys grading their symptoms. All patients underwent standardized videolaryngostroboscopic evaluation and computerized acoustic analysis. Patients then underwent a uniform therapy of dietary restrictions and omeprazole, a hydrogen ion inhibitor, for 12 weeks. Patients were then retested. This regimen demonstrated an 85% success of relieving symptoms. Utilizing the new laryngoscopic grading system, improvement was found to be statistically significant in improvement of all findings except granulomas. In patients with the pretherapy complaint of hoarseness, acoustic measures of jitter, shimmer, habitual frequency, and frequency range all showed significant improvement. The authors conclude that in patients with symptomatic reflux laryngitis, standardized videolaryngoscopy and, if hoarse, acoustic analysis are useful exam techniques to aide diagnosis and monitor therapy. Anti-reflux therapy with omeprazole is effective and improvement can be objectively demonstrated with the techniques described.
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PMID:Subjective, laryngoscopic, and acoustic measurements of laryngeal reflux before and after treatment with omeprazole. 894 45

Gastroesophageal reflux disease is increasingly being recognized as a common factor contributing to asthma and many ear, nose, and throat complaints. For example, studies suggest that acid reflux is present in 50% to 80% of asthmatic patients, 10% to 20% of chronic coughers, up to 80% of patients with difficult-to-manage hoarseness, 25% to 50% of patients with globus sensation, and a small but definite group of patients with laryngeal cancer. Clinical suspicion is the key to the diagnosis because many patients do not have classic reflux symptoms of heartburn or acid regurgitation. Prolonged esophageal pH monitoring with pH probes in the distal esophagus and proximal esophagus or hypopharynx and laryngeal examinations are the most helpful diagnostic tests. Prolonged acid suppression, either medically or surgically, will cure or help many of these patients.
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PMID:Extraesophageal presentations of gastroesophageal reflux disease. 910 95

Measures of vocal intensity, frequency and harshness were compared for 19 hearing-impaired and 21 normal-hearing people over 60 years of age. Significantly greater comfortable intensity levels were found in the hearing-impaired group, but the other measures of frequency and harshness were not significantly different. A large proportion of the subjects in both groups reported a history of gastro-oesophageal reflux (GER), a condition associated with vocal fold pathology and hoarseness. Comparison of the GER and non-GER subjects on the measures of vocal function showed that the female GER speakers exhibited lower frequency on the vowel /u/ than the non-GER subjects. Clinicians need to be aware of the effect of highly prevalent disorders such as hearing impairment and GER on the voices of elderly speakers.
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PMID:The effect of hearing impairment on the vocal characteristics of older people. 919 88

Laryngopharyngeal reflux is a new term given to gastroesophageal reflux leading to atypical symptoms in the upper aerodigestive tract. The manifestations of laryngopharyngeal reflux are varied and include chronic hoarseness, globus pharyngeus, sore throat, chronic cough, asthma, paroxysmal laryngospasm, and other less common symptoms. Making the diagnosis requires accurate history taking and can be confirmed by fiberoptic examination of the pharynx and larynx, as well as by ambulatory esophageal and pharyngeal pH monitoring. Stepwise treatment regimens are very effective in treating this condition, which exacerbates or imitates many seemingly unrelated disorders.
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PMID:Laryngopharyngeal reflux: a modern day "great masquerader". 932 11

Extraesophageal manifestations of gastroesophageal reflux disease (GERD) include chronic cough, asthma and 'acid' laryngitis. The response to medical and/or surgical therapy of these conditions is highly variable and often delayed. Of patients with GERD-related symptoms, those with extraesophageal manifestations are some of the most difficult to treat. Histamine antagonists, proton pump inhibitors and antireflux surgery have all been used to treat GERD-related asthma with variable results. Asthma patients who do not respond to high-dose acid suppression may be refractory to all forms of therapy. GERD is the third most common cause of chronic cough, and therapeutic results with acid suppression and antireflux surgery are variable. Posterior laryngitis presents as chronic hoarseness and has been shown to resolve clinically and histologically with acid suppression therapy or antireflux surgery. Results are variable, and controlled trials are lacking.
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PMID:Treatment of extraesophageal manifestations of gastroesophageal reflux disease. 934 89

Ambulatory pH monitoring of the distal esophagus is the most accurate diagnostic study for patients with suspected gastroesophageal reflux disease (GERD). The measurement of proximal esophageal acid exposure time may be useful in patients with atypical reflux symptoms. The aim of this study is to evaluate if proximal esophageal pH monitoring provides useful information beyond that learned with distal esophageal pH monitoring. We routinely performed dual-channel pH monitoring with pH electrodes positioned at 20 and 5 cm above the manometric lower esophageal sphincter from January 1992 to August 1995. All patients scored their esophageal symptoms from zero (none) to four (severe). We compared proximal esophageal reflux (PR) in patients with typical symptoms (i.e., heartburn, regurgitation) and in patients with atypical symptoms (i.e., chest pain, cough, hoarseness, and asthma). We compared symptom profiles between patients with and without PR. We reviewed our experience in patients with abnormal PR, but with a normal amount of distal esophageal reflux (DR). We studied 441 consecutive patients. There were no significant differences in PR between patients with typical and atypical symptoms. There were no differences in symptom profiles between patients with normal and abnormal PR. There were no differences of PR between the different atypical symptoms. PR did not correlate with the severity of the patient's symptoms. PR correlated well only with DR. Twenty-four patients had isolated abnormal PR, but only six patients improved with antireflux therapy. We conclude that routine ambulatory esophageal pH monitoring of the proximal esophagus appears to be of little value. The decision to offer patients an empiric trial of antireflux therapy for suspected GERD should not be based on the presence or absence of PR.
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PMID:Dual-channel ambulatory esophageal pH monitoring. A useful diagnostic tool? 939 98


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