Primary upper aerodigestive tract manifestations of gastroesophageal reflux.

Chronic hoarseness, chronic sore throat, "lump in the throat," or cervical pain with swallowing were the primary complaints in 25 (6.6%) of 379 patients undergoing esophagoscopy for gastroesophageal reflux at the Denver Veterans Administration Medical Center between 1981 and 1985. In 18 (72%) of the 25 patients, these were the only reflux symptoms. Surgery was required to control symptoms in nine (36%) patients with upper aerodigestive tract complaints, versus 52 (15%) of 354 patients with more typical reflux symptoms (z = 2.77, p less than 0.01). Surgery was also necessary more often in patients with chronic hoarseness or sore throat (seven of 15) than in those with "lump in the throat" or cervical pain with swallowing (two of 10). These findings suggest reflux does cause otherwise unexplained upper aerodigestive tract symptoms, and that surgery may be required more often to control these symptoms than is the case in patients with more typical symptoms of reflux.