Extraesophageal Manifestations of Gastroesophageal Reflux Disease / 대한내과학회지

ABSTRACT

Gastroesophageal reflux disease (GERD) is prevalent in Korea. Clinical manifestations include typical symptoms which are heartburn and regurgitation and atypical symptoms that can be esophageal or extraesophageal. Various extraesophageal manifestations are associated with GERD, and the most significant of these are chronic cough, laryngitis, and asthma. The diagnosis of extraesophageal syndrome is often difficult due to the poor sensitivity and specificity of available diagnostic modalities, including endoscopy, pH monitoring, and laryngoscopy. Consequently, empirical treatment with a proton pump inhibitor (PPI) is considered to be the most cost-effective tool for the diagnosis and management of patients suspected of having extraesophageal syndrome without alarm features. Those who do not respond to PPI therapy should undergo an additional work-up that includes monitoring esophageal pH or impedance, and motility tests to evaluate the relationship between reflux and symptoms. Surgical management should cautiously be considered for very carefully selected patients.