Bernard F, Dupont C, Viala P
Pediatric Gastroenterology Unit, Hôpital Saint Vincent de Paul, Paris, France.
Clin Rev Allergy. 1990 Winter;8(4):403-25.
GER can have important impacts on the upper airway passages, and in turn, upper airway obstruction can certainly aggravate reflux. This relationship should be considered in the newborn or young infant, faced with a sudden life-threatening event, and in the older child or adult presenting with chronic head and neck complaints, either unexplained or unresponsive to adequate medical therapy. A causal relationship may be difficult to establish, based first on clinical expertise as a guideline, on laboratory tests, among which pharyngeal pH monitoring could be promising, and on response to medical antireflux therapy. A better understanding of the significance of high levels of reflux and defective acid clearance, as well as a more precise knowledge of the maturation and functioning of upper airway protective mechanisms, would open the way to more accurate diagnostic procedures, to a more reliable definition of the abnormal, and to greater efficiency in the management of these patients.
胃食管反流（GER）可对上呼吸道产生重要影响，反之，上呼吸道梗阻肯定会加重反流。对于面临突发危及生命事件的新生儿或幼儿，以及出现不明原因或对充分药物治疗无反应的慢性头颈部症状的大龄儿童或成人，都应考虑这种关系。基于临床专业知识作为指导方针、实验室检查（其中咽pH监测可能很有前景）以及对抗反流药物治疗的反应，可能难以确定因果关系。更好地理解高水平反流和酸清除功能缺陷的意义，以及对上呼吸道保护机制的成熟和功能有更精确的认识，将为更准确的诊断程序、对异常情况更可靠的定义以及对这些患者管理的更高效率开辟道路。
