Beyond heartburn: Extraesophageal manifestations of gastroesophageal reflux disease

A variety of extraesophageal presentations of chronic acid reflux disease m ay be encountered in practice, and it is important to diagnose and manage t hem appropriately. Some of these patients are asymptomatic; others have sym ptoms most commonly associated with a pul monary or otolaryngologic disorde r. An aggressive trial of antireflux medication can often improve or resolv e these symptoms, indicating that gastroesophageal reflux disease is the pr imary contributing component. In cases where such medication trials fail, a dditional diagnostic methods may be needed to determine the source of the s ymptoms.