Updates in the field of non-esophageal gastroesophageal reflux disorder.

Abstract

Introduction: Gastroesophageal reflux disease (GERD) is one of the most prevalent conditions in Western Countries, normally presenting with heartburn and regurgitation. Extra-esophageal (EE) GERD manifestations, such as asthma, laryngitis, chronic cough and dental erosion, represent the most challenging aspects from diagnostic and therapeutic points of view because of their multifactorial pathogenesis and low response to proton pump inhibitors (PPIs). In fact, in the case of EE, other causes must by preventively excluded, but instrumental methods, such as upper gastrointestinal endoscopy and laryngoscopy, have low specificity and sensitivity as diagnostic tools. In the absence of alarm signs and symptoms, empirical therapy with a double-dose of PPIs is recommended as a first diagnostic approach. Subsequently, impedance-pH monitoring could help to define whether the symptoms are GERD-related. Areas covered: This article reviews the current literature regarding established and proposed EE-GERD, reporting on all available options for its correct diagnosis and therapeutic management. Expert opinion: MII-pH could help to identify a hidden GERD that causes EE. Unfortunately, standard MII-pH analysis results are often unable to define this association. New parameters such as the mean nocturnal baseline impedance and post-reflux swallow-induced peristaltic wave index may have an improved diagnostic yield, but prospective studies using impedance-pH are needed.

• Authors: Matteo Ghisa, Marco Della Coletta, Ilenia Barbuscio, Elisa Marabotto, Brigida Barberio, Marzio Frazzoni, Nicola De Bortoli, Patrizia Zentilin, Salvatore Tolone, Andrea Ottonello, Greta Lorenzon, Vincenzo Savarino, Edoardo Savarino
• Journal: Expert review of gastroenterology & hepatology (Expert Rev Gastroenterol Hepatol) Vol. 13 Issue 9 Pg. 827-838 (Sep 2019) ISSN: 1747-4132 [Electronic] England
• PMID: 31322443 (Publication Type: Journal Article, Review)

Topics

• Asthma (etiology)
• Chronic Disease
• Cough (etiology)
• Gastroesophageal Reflux (complications, epidemiology)
• Humans
• Laryngitis (etiology)
• Tooth Erosion (etiology)