Gastroesophageal reflux disease with chronic respiratory symptoms

Background: It is established that gastroesophageal reflux disease (GERD) may be the one of etiologic factors of intrinsic asthma, chronic cough, posterior laryngitis, hoarsness and sleeping apnoe.

Aim: The aim of the present study was to investigate the prevalnce of GERD in the patients with chronic respiratory symptoms.

Methods: 35 patients (average age: 54 years [19–81]) referred by pulmonologists were examined. Endoscopy, esophageal manometry, 24 hours pH metry or PPI-test were performed in patinets.

Results: Chronic cough were found in 17/35 patients, hoarsness in 7/35 patients, chronic bronchitis in 6/35 patients, dyspnoe in 3/35 patients, asthma bronchiale in 2/35 patients and pneumonia in 1/35 patient. Upper gastrointestinal endoscopy releaved erosiv esophagitis in 10/16 patients, non-erosive esophagitis in 5/16 patients and Barrett's esophagus was present in 1/16 patient. Esophageal manometry showed incompetent LES in 8/16 patients, motility dysfunction in 2/16 patients and both incompetent LES and motility dysfunction in 1/16 patient. 24 hours pH metry showed significant acid reflux in 6/16 patients, symptom-index positive was found in 2/16 patients and reflux period was longer than 5 minutes in 5/16 patients.

Conclusion: Gastroesophageal acid reflux was found to play etiologic role in 30% of chronic respiratory symptoms of patients referred by pulmonologists. Biliary or volume reflux may play role in the development of respiratory symptoms of the additional patient.

This study was supported by the grant ETT 550/2002.