Prevalence of extra‐oesophageal manifestations in gastro‐oesophageal reflux disease: an analysis based on the ProGERD Study

Jaspersen, D; Kulig, Michael; Labenz, Joachim; Leodolter, Andreas; Lind, Tore; Meyer‐Sabellek, W.; Vieth, Michael; Willich, Stefan N.; Lindner, Dirk; Stolte, Manfred; Malfertheiner, Peter

doi:10.1046/j.1365-2036.2003.01606.x

Cited by 253 publications

(275 citation statements)

References 29 publications

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“…38 Smoking has also been associated with extra-oesophageal complications. 12 In the present study, smokers as a group did not differ from nonsmokers in the extent of GER. Yet, smoking was an independent predictor of GERD symptoms.…”

Section: Discussioncontrasting

confidence: 44%

“…9,10 Furthermore, in many instances, the clinical presentation of GERD may be atypical, with hoarseness, asthma or chest pain as the sole manifestations. 3,8,11,12 The pathophysiology of GERD-related symptoms is complex. Oesophageal acid exposure (OAE) is significantly correlated with GERD symptoms measured either by a visual analogue scale 13 or by a validated Likert scale.…”

Section: Introductionmentioning

confidence: 99%

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Irritable bowel, smoking and oesophageal acid exposure: an insight into the nature of symptoms of gastro‐oesophageal reflux

Zimmerman¹

2004

Aliment Pharmacol Ther

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Summary Background : In gastro‐oesophageal reflux disease, oesophageal acid exposure correlates with symptoms but explains only a small fraction of their variance. Aims : To elucidate the effects of irritable bowel syndrome and smoking on gastro‐oesophageal reflux disease symptoms and to clarify whether they modulate the relationship between oesophageal acid exposure and symptoms. Methods : The relationship between oesophageal acid exposure, irritable bowel syndrome (Rome I criteria), smoking status and symptoms was investigated in patients with a normal gastroscopy who underwent a 24‐h oesophageal pH monitoring. Results : Of 256 patients with gastro‐oesophageal reflux disease, 16% were smokers and 50% met the criteria for irritable bowel syndrome (irritable bowel syndrome+). The extent of oesophageal acid exposure was unrelated to smoking or irritable bowel syndrome status. Oesophageal acid exposure, irritable bowel syndrome status and current smoking independently predicted symptoms. Irritable bowel syndrome and smoking modulated the effect of oesophageal acid exposure on symptoms: oesophageal acid exposure was predictive of symptoms only in non‐smokers. However, irritable bowel syndrome was a significant predictor of symptoms both in smokers and in non‐smokers. Smoking was associated with symptoms only in irritable bowel syndrome+, while oesophageal acid exposure was associated with symptoms irrespective of irritable bowel syndrome status. Conclusions : In patients with non‐erosive gastro‐oesophageal reflux disease, smoking and irritable bowel syndrome independently predicted symptoms, without affecting the extent of oesophageal acid exposure. The relationship between oesophageal acid exposure and symptoms was affected significantly, and in opposite directions, by smoking and irritable bowel syndrome.

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Section: Discussioncontrasting

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Irritable bowel, smoking and oesophageal acid exposure: an insight into the nature of symptoms of gastro‐oesophageal reflux

Zimmerman¹

2004

Aliment Pharmacol Ther

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“…1 LPR is an extraesophageal manifestation of gastroesophageal reflux disease (GERD) and there are a large number of data on the growing prevalence of laryngopharyngeal symptoms in up to 60% in patients with GERD. 2,3 Laryngopharyngeal symptoms are increasingly recognized by general physicians, lung specialist and otorhinolaryngologist. 4 Because there are few accurate diagnostic methods of the disease, there is a question of who should diagnose and treat patients with suspected laryngopharyngeal disease.…”

Section: Introductionmentioning

confidence: 99%

Interrater Reliability among Endoscopists: Diagnosis of Laryngopharyngeal Reflux Based on the Reflux Finding Score Determined by Upper Endoscopy

Lee

Bang

Kim

et al. 2017

Korean J Helicobacter Up Gastrointest Res

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Background/Aims: Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of gastroesophageal reflux disease. Endoscopic assessment of LPR is needed for convenient diagnosis and documentation of treatment efficacy. The aim of this study was to investigate the interrater reliability of LPR among endoscopists based on endoscopic laryngeal images. Materials and Methods: Nineteen endoscopists participated in this study. Before the test, they completed an intensive education program by an otorhinolaryngologist on the reflux finding score (RFS), which is a validated laryngoscopic assessment of LPR. A total of 100 endoscopic laryngeal images were used for 3 tests of RFS. Cohen's and Fleiss' kappa coefficients were used to determine the degree of interrater agreement in the diagnosis of LPR. Results: In the first test, the mean of Cohen's kappa coefficients for LPR diagnosis between the otorhinolaryngologist and each of the 19 endoscopists was 0.3. In the second test, after additional education, the mean kappa value was 0.32.

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“…Increased GER is the third most common cause of chronic cough [3] and according to Jaspersen et al cough is common either in erosive (30.5 %) and non-erosive (34.9 %) reflux disease. [4] To better understand the relationship between reflux and cough and provide a rationale …”

Section: Introductionmentioning

confidence: 99%

Cough and gastroesophageal reflux: From the gastroenterologist end

Pauwels¹,

Blondeau²,

Dupont³

et al. 2009

Pulmonary Pharmacology & Therapeutics

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Gastroesophageal reflux (GER) is one of the three most common causes of chronic unexplained cough. Diagnosing GER related cough is challenging since many patients do not have esophagitis or an increased esophageal acid exposure during 24h esophageal pH-metry. A significant time association between acid reflux and cough can be demonstrated in a subgroup of patients, even if the total esophageal acid exposure is normal. Establishing an exact time relationship between reflux and cough requires objective measurements of both cough and reflux episodes. A variety of techniques for cough assessment are available, including sound recordings and continuous measurement of gastroesophageal pressures. The Symptom Association Probability (SAP) has been suggested as the most reliable algorithm to establish the non-chance association between GER and cough. Although the relationship between acid reflux and cough is generally accepted, the response rate of patients with chronic unexplained cough to proton pump inhibitor treatment (PPI) is poorer compared to that in patients with typical GERD symptoms. Combined impedance-pH recordings, a new technique for the measurement of all types of reflux, have recently shown that not only acid but also weakly acidic GER may be associated with cough. Moreover, measurements in patients "on" PPI therapy demonstrated that weakly acidic reflux may persist during PPI treatment and may be associated with cough.

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Prevalence of extra‐oesophageal manifestations in gastro‐oesophageal reflux disease: an analysis based on the ProGERD Study

Cited by 253 publications

References 29 publications

Irritable bowel, smoking and oesophageal acid exposure: an insight into the nature of symptoms of gastro‐oesophageal reflux

Irritable bowel, smoking and oesophageal acid exposure: an insight into the nature of symptoms of gastro‐oesophageal reflux

Interrater Reliability among Endoscopists: Diagnosis of Laryngopharyngeal Reflux Based on the Reflux Finding Score Determined by Upper Endoscopy

Cough and gastroesophageal reflux: From the gastroenterologist end

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