EXTRADIGESTIVE MANIFESTATIONS OF GASTROESOPHAGEAL REFLUX DISEASE: DEMOGRAPHIC, CLINICAL, BIOLOGICAL AND ENDOSCOPIC FEATURES.

UNLABELLED: Gastroesophageal reflux disease (GERD) with extradigestive manifestations is a disorder increasingly recognized both by gastroenterologists, pneumologists, otolaryngologists and cardiologists. AIM: To evaluate the demographical, clinical, biological and endoscopic features of the patients with gastroesophageal reflux disease and extradigestive manifestations (chronic laryngitis, asthma, pseudoangina). MATERIAL AND METHODS: Prospective case-control study, including 137 patients selected from patients referred to the Iasi Institute of Gastroenterology and Hepatology between July 2014-September 2015. In the presence of typical GERD symptoms (heartburn or regurgitation), the patients were assessed by upper digestive endoscopy for the detection or exclusion of esophagitis. Despite the absence of esophageal lesions, the patients were further assessed by impedance-pHmetry. RESULTS: Depending on the dominant extradigestive manifestation, the patients were assigned into 3 groups: 94 chronic laryngitis patients, 24 asthma patients and 19 pseudoangina patients. Females were more frequent among pseudoangina patients (68.4%). Mean age of the male patients with dysphonia or asthma was lower (p=0.002), the majority (78.1%) living in urban areas. Obesity was predominant in pseudoangina group (52.6%), as compared to dysphonia group (16%) the differences being statistically significant (p=0.002). A share of 57.9% of pseudoangina patients were dyslipidemic, in contrast to dysphonia (24.5%) or asthma group (37.5%) (p=0.013). Esophagitis was also more frequent at pseudoangina group (84.2%), but with no significant statistical difference between the study groups (79.8% and 75%, respectively) (p=0.115). It seems that Helicobacterpylori infection tends to be protective in patients with GERD and pseudoangina (RR=0.61), but it can not be extrapolated to the general population (p=0.459). CONCLUSION: GERD with extradigestive manifestations is a prevalent and heterogeneous disease. There are demographic, clinical, biological and endoscopic differences between patiens with extradigestive GERD.

THE TRIBES AND TRIBULATIONS OF LARYNGOPHARYNGEAL REFLUX: A REVIEW OF RECENT STUDIES WITH IMPLICATIONS FOR INTERDISCIPLINARY COLLABORATIONS BETWEEN OTOLARYNGOLOGISTS AND GASTROENTEROLOGISTS.

Laryngopharyngeal reflux has been recognized since 2006 (Montreal Consensus) as an extradigestive manifestation of gastroesophageal reflux disease. However, despite numerous research studies, the relationship between these two pathologies is yet to be fully understood. The aim of this paper is to review the literature of the last five years available via the PubMed database, looking at the controversies about the prevalence, pathophysiology and diagnosis of laryngopharyngeal reflux.

Overweight and gastrointestinal symptoms among adults of working age in Iasi City, Romania.

UNLABELLED: The objectives were to determine the presence of gastrointestinal symptoms and overweight in a sample of working age adults, from Iasi city (North-East Romania) and relationship with eating habits. MATERIAL AND METHODS: For this survey a sample was randomly chosen from family doctors records and 158 adults participated (65 males and 93 females, aged 19-64 years). Eating habits and food-frequency questionnaires were conducted, and Body Mass Index (BMI), waist and Body Fat Percent (FAT) were measured. For recent symptoms we used Gastrointestinal Symptom Rating Scale (GSRS). RESULTS: 43.1% of male and 47.3% of female were overweight and 21.5% of male and 21.6% of female were obese. The total body fat exceeded its normal limits in 70.8% of men and in 32.3% of women. Waist was high (abdominal obesity) in 49.5% of women and in 26.2% of men. Present gastrointestinal symptoms were: reflux (23.4%), abdominal pain (8.9%), indigestion (32.9%), diarrhea (6.3%) and constipation (8.9%). Overweight or obese subjects accused reflux, indigestion (p < 0.01) and constipation (p < 0.05) more frequently than those with normal weight. Odd ratio value and 95% confidence interval for obese versus normal weighted subjects was 8.23 (2.15-37.58) for reflux and 11.65 (3.34-45.5) for indigestion. CONCLUSIONS: Our findings up-date epidemiological data and suggest the need to promote healthy eating habits in order to reduce the tendency of obesity and to improve digestive function in population.