Patient with laryngitis or cough and suspicion of GERD

Peter Malfertheiner

What findings in history or physical examination in a patient with laryngitis or chronic cough should raise the suspicion of gastroesophageal reflux disease (GERD)?

Peter Malfertheiner: This is a very hot topic, because when people go to the ear, nose, and throat physician and they do not find a local condition that explains the symptoms, they say, “go to the gastroenterologist” and look whether they have reflux disease. There are many of these patients in whom we do not find reflux disease; I would say it is in the order of 10% to 15% of patients who have only these symptoms that we identify reflux disease. However, if patients in addition to these so-called atypical symptoms have reflux symptoms, like heartburn, upper gastrointestinal (GI) pain, or a kind of pressure retrosternally, then the likelihood that it is reflux is very high and in these patients, of course, it is easy to identify the cause.

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