gastroesophageal reflux and Respiratory Conditions

Respiratory Conditions

GERD is associated with numerous respiratory conditions. Approximately 10% of patients presenting to ENT specialists have conditions that may be attributed to GERD.23 One study revealed that GERD is present in 75% of individuals with refractory ENT symptoms, and PPI therapy provided symptom relief or reduction in the majority of these individuals. Asthma is associated with the presence of GERD symptoms, and although the relationship has not been well-studied. It is estimated that prevalence of GERD in people with asthma is between 60%– 80% in adults and 50%–60% in children. Although the direct correlation is unknown, researchers have suggested that reflux aggravates asthma, which in turn induces further reflux.( Poelmans J, et al ,2006)

GERD is associated with a chronic nonproductive cough in some individuals; the cough occurs primarily during the day and while these patients are in an upright position. One study demonstrated that chronic cough was caused by reflux in 21% of cases. In addition, the researchers showed that chronic cough was the sole presenting symptom in GERD 43% of the time.( Loehrl TA, et al , 2004)

Otitis media may also be linked to GERD. A study examining otitis media with effusion in adults demonstrated that pepsinogen concentration was higher in middle-ear effusion in patients who reported GERD symptoms. In addition, treatment for GERD with PPIs provided some patients with GERD symptom relief as well as decreasing the concentration of pepsinogen in the effusion. Additionally, research has indicated that patients with chronic rhinosinusitis have an increased prevalence of GERD. These chronic rhinosinusitis symptoms in many patients are reduced when their GERD is treated.28 Laryngeal symptoms may be associated with GERD. Often, they present as hoarseness, frequent throat clearing, a postnasal drip, excess phlegm, sore throat, dysphagia, a globus sensation, or cough. Chronic laryngitis and chronic sore throat are associated with GERD in as many as 60% of patients. In addition, one study showed that at least 50% of patients presenting with laryngeal and voice disorders had laryngopharyngeal reflux. Less-common GERD-related laryngopharyngeal disorders include paroxysmal laryngospasm, subglottic stenosis, vocal-cord granuloma, and laryngeal and pharyngeal carcinoma.( Franco RA, et al , 2006)