Division of Gastroenterology, Hepatology, and Nutrition, Center for Swallowing and Esophageal Disorders, Vanderbilt University Medical Center, C2104-MCN Nashville, TN, USA.
Best Pract Res Clin Gastroenterol. 2013 Jun;27(3):415-31. doi: 10.1016/j.bpg.2013.06.009.
Reflux related cough, asthma and laryngitis are frequently encountered and are considered part of extraoesophageal syndromes. The diagnosis of extraoesophageal reflux is difficult due to the lack of gold standard diagnostic criteria. Esophagogastroduodenoscopy and esophageal pH monitoring are inadequate diagnostic tools for due to poor sensitivity and specificity. For this reason, empirical PPI therapy is recommended as an initial approach to diagnose and treat the potential underlying cause of these symptoms in patients without alarm symptoms. Diagnostic testing with esophageal pH and/or impedance monitoring and esophageal motility testing is usually reserved for those who continue to be symptomatic despite a trial of therapy with PPIs. Recent developments have increased our understanding of this difficult to treat group of patients but more research into reflux related extraoesophageal symptoms are needed to better diagnose and treat this group.
反流相关咳嗽、哮喘和喉炎是常见的疾病，被认为是食管外综合征的一部分。由于缺乏金标准诊断标准，食管外反流的诊断较为困难。由于敏感性和特异性较差，食管胃十二指肠镜检查和食管 pH 监测不是充分的诊断工具。因此，建议对无报警症状的患者采用经验性 PPI 治疗作为诊断和治疗这些症状潜在根本原因的初始方法。对于那些尽管接受了 PPI 治疗但仍持续有症状的患者，通常会进行食管 pH 和/或阻抗监测和食管动力测试等诊断性检查。最近的发展增加了我们对这组难以治疗的患者的理解，但需要更多的研究来更好地诊断和治疗这组与反流相关的食管外症状患者。
