Your browser doesn't support javascript.
loading
Update on extraesophageal manifestations of gastroesophageal reflux.
Fernandez, Annel M; Chan, Walter W.
Afiliação
  • Fernandez AM; Department of Medicine, Brigham and Women's Hospital.
  • Chan WW; Harvard Medical School.
Curr Opin Gastroenterol ; 40(4): 305-313, 2024 Jul 01.
Article em En | MEDLINE | ID: mdl-38662405
ABSTRACT
PURPOSE OF REVIEW Symptoms/complications related to extraesophageal reflux (EER) are increasingly prevalent presentations and pose significant challenges for clinicians. We summarize and discuss clinical advances and developments in pathophysiology, testing and treatment algorithms of upper/lower airway manifestations of EER. RECENT

FINDINGS:

Growing evidence supports likely multifactorial causes of laryngeal symptoms, including EER, oropharyngeal pathologies, allergic conditions, and cognitive-affective processes (brain-larynx interaction). Diagnostic paradigm for laryngopharyngeal reflux (LPR) is shifting towards a personalized approach with noninvasive strategies/prediction tools to risk-stratify patients for upfront reflux testing over empiric acid suppression trials. Management should be multipronged to include antireflux therapies and treatments targeting other causes. Lower airway complications of EER may result in lung dysfunction and poor transplant outcomes. Esophageal symptoms are often absent and routine esophageal/reflux testing to guide timely antireflux therapies may lead to improved outcomes. Modalities that leverage impedance technology may be important, given the potential role of nonacidic reflux. Novel impedance-based metrics such as mean nocturnal baseline impedance and postreflux swallow-induced peristaltic wave index may provide adjunctive diagnostic values.

SUMMARY:

Standardized approach to diagnosis/management of EER should include multidisciplinary care teams and consider different phenotypes, nonreflux contributors, and the complex gut-airway relationships. Prompt antireflux therapies after careful candidate selection may improve outcomes of these airway complications.
Assuntos

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Refluxo Gastroesofágico Limite: Humans Idioma: En Revista: Curr Opin Gastroenterol Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Refluxo Gastroesofágico Limite: Humans Idioma: En Revista: Curr Opin Gastroenterol Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2024 Tipo de documento: Article