Extraoesophageal manifestations of reflux disease in laryngology

Gastroesophageal reflux disease is a digestive disorder in which the excessive reflux of gastric contents into the oesophagus gives bothersome symptoms and/or results in complications. Acidic gastric contents flowing back up beyond the oesophagus cause nonspecific, apparently unrelated to the disease, symptoms of mucosal inflammation in the upper gastrointestinal and respiratory tracts.

The symptoms reported include throat clearing, sore throat, heartburn, globus sensation, polydipsia (excessive thirst), hypersalivation (drooling), chronic cough, haemoptysis, stridor, sustained or paroxysmal dyspnoea, paroxysmal laryngospasms, hoarseness, and vocal fatigue. Patients may also complain of dysphagia, regurgitation, constant swallowing, bad breath, otalgia, mandibular and neck pain, and abdominal and non-cardiac chest pain.

Treatment of extra-oesophageal reflux should be a staged process. First, the patient should be instructed to change their bad habits. The medications used are proton pump inhibitors. The optimal length of treatment is six months.

In contrast to patients with GERD, patients with LPR do not respond to treatment in a satisfactory manner.