Laryngeal signs and symptoms and gastroesophageal reflux disease (GERD): a critical assessment of cause and effect association

Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease

“…Whether these technical improvements increase the yield of symptom association analysis in patients with cough attributed to refl ux requires further studies. Laryngoscopic fi ndings, especially edema and erythema, are oft en used to diagnose refl ux-induced laryngitis ( 134 ). It should be pointed out that laryngoscopy revealed one or more signs of laryngeal irritation in over 80 % of healthy controls in a well-done prospective study ( 135 ).…”

Laryngopharyngeal reflux in patients with reflux esophagitis

“…The RFS is an 8-item clinical severity scale based on findings during fiberoptic laryngoscopy. However, this RFS system has been criticized to have high inter-or intra-observer variability and low specificity for reflux laryngitis [6,10,19] . Therefore, it is very important to exclude meticulously other potential etiologies that can lead to laryngeal irritation.…”

Proton pump inhibitors in gastroesophageal reflux disease: a custom-tailored therapeutic regimen

“…The body mass index (BMI) showed a direct association with PS (BMI: < 25: -0.068 ± 0.03 vs. 25-30: 0.012 ± 0.03 vs. > 30: 0.13 ± 0.04, p < 0.001). This suggests the hypothesis that age may be associated to URS, while factor 2 is associated to BMI (60). The pathophysiological mechanisms of GERD-related chronic cough are (61): a) the intraesophageal acid that stimulates esophageal-tracheal-bronchial cough reflex; and b) micro-aspiration, if cough fits are correlated to acid GERD episodes it may be a sufficient cause, even with a normal 24-h pH; if the latter is abnormal, it does not necessarily mean it is the cause.…”