What to Do About Bizarre Esophageal Symptoms
What to Do About Bizarre
Esophageal Symptoms?
Robert H. Lee, MD, MAS
Clinical Associate Professor of Medicine
Director of GI Motility
H.H. Chao Comprehensive Digestive Disease Center
University of California Irvine
Is GERD to Blame?
Discover ? Teach ? Heal
Extra-Esophageal GERD
? ENT
? Pulmonary
-
-
Globus
Hoarseness
Laryngitis
Otitis
Pharyngitis
Sore Throat
Subglottic stenosis
Vocal Cord Granulomas
Chronic Cough
Asthma
Pulmonary fibrosis
Pneumonia
? Miscellaneous
- Non-Cardiac Chest Pain
- Dental erosions
Vaezi et al. Clin Cornerstones 2003
Discover ? Teach ? Heal
Objectives
? Non-Cardiac Chest
Pain (NCCP)
? Throat and Cough
Symptoms
? Is there evidence that
GERD is a cause?
? What are the best
diagnostic tools?
? How effective are GERD
treatments?
? If not GERD, then what?
Discover ? Teach ? Heal
Non-Cardiac Chest Pain
? Evidence for GERD as a cause
- NCCP reported in 37% with weekly heartburn vs
7.9% without GERD symptoms
- Heartburn is the only reliable risk factor for
NCCP (OR=1.74, 95% CI: 1.08-2.79)
1) Locke et al. Gastroenterology 1997 2) Eslick et al. Aliment Pharmacol Ther 2003
Discover ? Teach ? Heal
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