Madanick Ryan D
Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, CB# 7080, Chapel Hill, NC 27599, USA.
Gastroenterol Clin North Am. 2014 Mar;43(1):105-20. doi: 10.1016/j.gtc.2013.11.007. Epub 2013 Dec 28.
This article reviews the evaluation and management of patients with suspected extraesophageal manifestations of gastroesophageal reflux disease, such as asthma, chronic cough, and laryngitis, which are commonly encountered in gastroenterology practices. Otolaryngologists and gastroenterologists commonly disagree upon the underlying cause for complaints in patients with one of the suspected extraesophageal reflux syndromes. The accuracy of diagnostic tests (laryngoscopy, endoscopy, and pH- or pH-impedance monitoring) for patients with suspected extraesophageal manifestations of gastroesophageal reflux disease is suboptimal. An empiric trial of proton pump inhibitors in patients without alarm features can help some patients, but the response to therapy is variable.
本文综述了胃食管反流病疑似食管外表现患者的评估与管理,如哮喘、慢性咳嗽和喉炎,这些情况在胃肠病学实践中较为常见。对于疑似食管外反流综合征之一的患者,耳鼻喉科医生和胃肠病科医生通常对其主诉的潜在病因存在分歧。胃食管反流病疑似食管外表现患者的诊断测试(喉镜检查、内镜检查以及pH或pH阻抗监测)准确性欠佳。对无警示特征的患者进行质子泵抑制剂的经验性试验可能对部分患者有帮助,但治疗反应存在差异。