COMMENTARY

Atypical Manifestations of Gastroesophageal Reflux Disease

Michael F. Vaezi, MD, PhD, MSEpi

Disclosures

October 27, 2005

In This Article

Concluding Remarks

GERD and extraesophageal symptoms have a complex relationship. In many patients who have extraesophageal symptoms, reflux of acid or nonacid gastroduodenal contents may be a causal factor. However, in many others, although GERD may be implicated, reflux disease may play a minimal role. The current diagnostic tests lack specificity to help unravel this complex association. Thus, empiric therapy is currently the most specific tool to determine whether reflux disease is playing a significant role in patients' extraesophageal symptoms. The current recommendation in such patients is therapy with PPIs for at least 2-3 months. In those who respond to therapy, tapering the degree of acid suppression is the next step, whereas in those unresponsive to PPI therapy, causes other than GERD should be sought.

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