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Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-188X
HOT TOPICS IN OTOLARYNGOLOGY
Center for Voice and Swallowing, University of California, Davis Department of Otolaryngology/Head and Neck Surgery, Sacramento, CA, USA
Gastroesophageal reflux is a chronic, relapsing condition that affects nearly a third of the general United States population. The gastroesophageal reflux disease (GERD) is defined as chronic symptoms or complications caused by the retrograde movement of gastric contents into the esophagus. Peptic esophagitis may occur in the absence of patient symptoms, and a symptomatic individual may have a normal endoscopy. Both suffer from GERD. If a symptomatic patient has erosive esophagitis, the individual is said to have erosive reflux disease. If the patient suffers from troublesome symptoms in the absence of macroscopic esophagitis, the individual is said to have non-erosive reflux disease (NERD). The majority of patients with GERD do not have erosive esophagitis. Symptoms of GERD include heartburn, a feeling of burning in the chest, and regurgitation, a sensation of a bitter, sour tasting fluid. These symptoms are thought to be rather specific for GERD and usually respond to appropriate treatment. In contrast to these typical symptoms of GERD, reflux may also affect the upper aerodigestive tract. Laryngopharyngeal reflux (LPR) is defined as chronic symptoms or mucosal changes caused by the retrograde flow of gastric contents into the pharynx and larynx. Symptoms of LPR include intermittent dysphonia, throat clearing, throat pain, globus, the sensation of post-nasal drip, cough, dyspnea, asthma, and excessive throat mucus (water brash). It is important to note, however, that unlike the classic symptoms of heartburn and regurgitation as seen with GERD, these symptoms are non-specific, and may be caused by allergy, environmental pollutants such as tobacco and ground level ozone, and even cancer. Dysphagia, or difficulty swallowing, is a common sequelae of both GERD and LPR. The symptom can range from a mild sensation of food getting stuck in the throat to profound oropharyngeal dysfunction and a complete dependence on non-oral tube feeding. The purpose of this manuscript is to review the pathogenesis of reflux related dysphagia and discuss contemporary diagnostic and treatment strategies.