COMMENTARY

When Should Endoscopy Be Done in the Patient With Reflux?

M. Brian Fennerty, MD

Disclosures

March 10, 2003

In This Article

Endoscopy in the Evaluation of Patients Presenting With Atypical GERD Symptoms

The typical symptoms of GERD -- heartburn and regurgitation -- are quite reliable for making the diagnosis. However, patients with GERD may often present with reflux-related pulmonary or otolaryngologic symptoms in the absence of the typical symptoms indicated above.[7] These other, extraesophageal symptoms of GERD (eg, asthma, cough, and hoarseness) can be ambiguous, and may necessitate other diagnostic steps in order to establish a diagnosis of GERD.[7] Patients with these symptoms are often referred for confirmatory testing. Unfortunately, the sensitivity of endoscopy in these situations is limited. Conversely, diagnostic tests such as ambulatory esophageal pH monitoring and/or PPI therapy trials are often more useful than endoscopy in clarifying the etiology of such "atypical" symptoms.

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