Laryngospasm: An Atypical Manifestation of Severe Gastroesophageal Reflux Disease (GERD)

Abstract

Based on the data collected in these 8 individuals, patients with reflux disease (known or unknown) can develop severe laryngospasm and possible syncope. The key factor seems to be the association of a recent or concurrent upper respiratory infection that results in a protracted cough that is more severe when supine and at times violent. The cough increases the amount of the refluxate, which is the noxious insult to the larynx.

Cough Syncope Induced by Gastroesophageal Reflux

“…8) A cough can be the patient's principal presentation of the gastroesophageal reflux and in several prospective studies, it has accounted for 10-21% of cases with chronic cough. 9)10) However, syncope as a manifestation of a gastroesophageal reflux induced cough has rarely been described in the literature.…”

“…1) There are a number of different mechanisms reported as causes of cough syncope, such as elevated intrathoracic pressure, elevated cerebrospinal fluid pressure, and transient bradyarrhythmias. [2][3][4][5][6][7][8][9][10] We report here on a patient who was found to have gastroesophageal reflux with frequent syncope, and this was due to a transient fall of blood pressure after vigorous paroxysms of coughing. The frequency and strength of the cough become reduced markedly, and the syncope disappeared completely after the administration of antacids.…”

No Laughing Matter

“…Laryngospasm is often precipitated by gastroesophageal refleux disease and is a well-documented cause of syncope. 4 I surmised Mr XY's large meal and several glasses of beer were contributors to the gastroesophageal reflux, and that his bouts of laughter likely increased the reflux, thus leading to laryngospasm. We discussed dietary and behavior changes to decrease gastroesophageal reflux, and he was prescribed omeprazole.…”

Extraesophageal Reflux and Upper Aerodigestive Tract Diseases

“…EER is also highly associated with paroxysmal laryngospasm [21] . Many patients with laryngospasm respond to antirefl ux therapy [22] .…”