Document Detail

The impact of extra-esophageal reflux upon diseases of the upper respiratory tract.
MedLine Citation:
PMID:  18475079     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: The present paper examines the recent literature on extra-esophageal reflux and discusses how it affects patient testing and treatment of upper respiratory track inflammatory disease. RECENT FINDINGS: Assays for pepsin have been developed casting more insight into the pathophysiology of extra-esophageal reflux as well as looking at the role of protective factors in upper respiratory mucosa. Similarities and differences in esophageal and extra-esophageal reflux continue to be explored. Acid suppression in extra-esophageal reflux improves symptoms before physical findings, but some patients do not respond. Mildly acidic (pH > 4) and alkaline reflux are being examined more in extra-esophageal reflux with impedance testing playing a more prominent role. Recent studies have also focused on whether extra-esophageal reflux could affect tissues of the nasopharynx, sinuses, or middle ear. Caution has been issued as acid suppressive therapies have been associated with hip fracture in older patients. SUMMARY: Symptoms caused by reflux may reflect underlying weaknesses in mucosal resilience to acid and pepsin in addition to the variations in exposure to gastric contents. In some patients mildly acidic or alkaline reflux may be important and gastric contents may reach the nasopharynx or middle ear. Carefully designed placebo-controlled trials are needed.
James W Mims
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in otolaryngology & head and neck surgery     Volume:  16     ISSN:  1531-6998     ISO Abbreviation:  Curr Opin Otolaryngol Head Neck Surg     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-13     Completed Date:  2008-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9417024     Medline TA:  Curr Opin Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  242-6     Citation Subset:  IM    
Department of Otolaryngology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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MeSH Terms
Gastroesophageal Reflux / complications*,  physiopathology
Hydrogen-Ion Concentration
Laryngeal Diseases / etiology,  physiopathology
Otitis Media with Effusion / etiology,  physiopathology
Pepsin A / analysis
Respiratory Tract Diseases / etiology*,  physiopathology
Rhinitis / etiology,  physiopathology
Sinusitis / etiology,  physiopathology
Sleep Disorders / etiology,  physiopathology
Reg. No./Substance:

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