Gastroesophageal reflux disease (GERD) is a highly prevalent complex
chronic condition. The most extensive prospective and multicenter cohort study
conducted in Europe has estimated that one-third of the patients with GERD may
exhibit extra-esophageal symptoms. The Montreal Consensus recognized chronic
cough, chronic laryngitis, bronchial asthma and tooth erosions as extra-digestive
manifestations of GERD. The experts also considered that manifestations such as
recurrent otitis media, idiopathic pulmonary fibrosis, sinusitis or pharyngitis are likely
to be associated with GERD.
The traditional techniques used in the diagnosis of typical GERD are less useful for the
diagnosis of extra-digestive GERD. No single testing methodology exists to
definitively identify reflux as the etiology for the suspected extra-esophageal
symptoms. The PPI trial is the first diagnostic but also a therapeutic step, while
evaluation through esophageal impedance-pH monitoring currently represents the goldstandard for diagnosis.
Despite extensive work, extra-digestive GERD remains incompletely understood.
Keywords: Gastroesophageal reflux disease, Extra-digestive manifestations,
Esophageal impedance-pH monitoring, Proton pomp inhibitors.
