Abstract
Supraesophareal reflux disease is a form of acid reflux manifested not by heartburn but rather by respiratory or laryngeal symptoms. It is caused by reflux of acidic gastric contents into the larynx. Esophagoscopy is usually normal, but inspection of the larynx may reveal signs such as edema or erythema. Conventional pH monitoring is not sensitive enough to detect reflux to the upper esophagus, but the yield is improved with the combination of impedance monitoring (MII) with pH monitoring. Other possible diagnostic methods are the Dx–pH measurement system that measures aerosolized droplets of acid in the oropharynx, and salivary pepsin that can be used as a diagnostic marker. These methods, however, are not commonly available. Lifestyle modifications may improve the symptoms but the backbone of therapy is proton pump inhibitors. A therapeutic trial of proton pump inhibitor twice daily for 2 months is usually enough to produce symptomatic improvement. Some carefully selected patients may also benefit from anti-reflux surgery. Due to the nonspecific nature of the symptoms and the difficulty in diagnosis it is accepted that failure of a properly administered therapeutic trial should prompt further investigation for another diagnosis.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Richter JE, Friedenberg F. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, editors. Sleisenger and Fordtrans gastrointestinal and liver disease. 9th ed. Philadelphia: Saunders; 2010.
Kim KY, Kim GH, Kim DU, et al. Is ineffective esophageal motility associated with gastropharyngeal reflux disease? World J Gastroenterol. 2008;14(39):6030–5. doi:10.3748/wjg.14.6030.
Lin GG, Scott JG. Prevention of esophagopharyngeal reflux by augmenting the upper esophageal sphincter pressure. Laryngoscope. 2014;124(10):2268–74. doi:10.1016/j.pestbp.2011.02.012.Investigations.
Babaei A, Venu M, Naini SR, et al. Impaired upper esophageal sphincter reflexes in patients with Supraesophageal reflux disease. Gastroenterology. 2015;149(6):1381–91. doi:10.1053/j.gastro.2015.07.007.
Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). J Voice. 2002;16(2):274–7.
Passàli D, Caruso G, Passàli FM. ENT manifestations of gastroesophageal reflux. Curr Allergy Asthma Rep. 2008;8(3):240–4. doi:10.1007/s11882-008-0040-8.
Belafsky PC, Postma GN, Koufman JA. The validity and reliability of the reflux finding score (RFS). Laryngoscope. 2001;111(8):1313–7. doi:10.1097/00005537-200108000-00001.
Ozturan O, Dogan R, Yenigun A, Veyseller B, Yildrim YS. Photographic objective alterations for Laryngopharyngeal reflux diagnosis. J Voice. 2017;31(1):78–85.
Vaezi MF, Schroeder PL, Richter JE. Reproducibility of proximal probe pH parameters in 24-hour ambulatory esophageal pH monitoring. Am J Gastroentero. 1997;92:825–9.
Bardan E. Pharyngoesophageal pH monitoring. Am J Med. 2003;115(3 suppl. 1):3–5. doi:10.1016/S0002–9343(03)00202-X.
Tutuian R, Castell DO. Use of multichannel intraluminal impedance to document proximal esophageal and pharyngeal nonacidic reflux episodes. Am J Med. 2003;115(3 suppl. 1):119S–23S. doi:10.1016/S0002–9343(03)00209-2.
Wan Y, Yan Y, Ma F, et al. LPR: how different diagnostic tools shape the outcomes of treatment. J Voice. 2014;28(3):362–8. doi:10.1016/j.jvoice.2013.12.004.
Chiou E, Rosen R, Nurko S. Effect of different pH criteria on dual-sensor pH monitoring in the evaluation of supraesophageal gastric reflux in children. J Pediatr Gastroenterol Nutr. 2011;52(4):399–403. doi:10.1097/MPG.0b013e3181ef378b.
Dulery C, Lechot A, Roman S, et al. A study with pharyngeal and esophageal 24-hour pH-impedance monitoring in patients with laryngopharyngeal symptoms refractory to proton pump inhibitors. Neurogastroenterol Motil. 2017;29(1):1–8. doi:10.1111/nmo.12909.
Wiener GJ, Tsukashima R, Kelly C, et al. Oropharyngeal pH monitoring for the detection of liquid and aerosolized supraesophageal gastric reflux. J Voice. 2009;23(4):498–504. doi:10.1016/j.jvoice.2007.12.005.
Yadlapati R, Pandolfino JE, Lidder AK, Shabeeb N, Jaiyeola DM, Adkins C, Agrawal N, Cooper A, Price CP, Ciolino JD, Gawron AJ, Smith SS, Bove M, Tan BK. Oropharyngeal pH testing does not predict response to proton pump inhibitor therapy in patients with laryngeal symptoms. Am J Gastroenterol. 2016;111(11):1517–24.
Spyridoulias A, Lillie S, Vyas A, Fowler SJ. Detecting laryngopharyngeal reflux in patients with upper airways symptoms: symptoms, signs or salivary pepsin? Respir Med. 2015;109(8):963–9. doi:10.1016/j.rmed.2015.05.019.
McGlashan JA, Johnstone LM, Sykes J, et al. The value of a liquid alginate suspension (Gaviscon advance) in the management of laryngopharyngeal reflux. Eur Arch Otorhinolaryngol. 2009;266:243–51.
Khan M, Santana J, Donnellan C, et al. Medical treatments in the short term management of reflux oesophagitis. Cochrane Database Syst Rev. 2007;2:CD003244.
Richter JE. Medical management of patients with esophageal or supraesophageal gastroesophageal reflux disease. Am J Med. 2003;115(3 Suppl. 1):179S–87S. doi:10.1016/S0002–9343(03)00221-3.
Ogawa M, Hosokawa K, Iwahashi T, Inohara H. The results of Kaplan-Meier and multivariate analyses of etiological factors related to the outcome of combined pharmacological therapy against laryngeal granuloma. Acta Otolaryngol. 2016;6489:1–6. doi:10.1080/00016489.2016.1193891.
Yuksel ES, Vaezi MF. Therapeutic strategies for laryngeal manifestations of gastroesophageal reflux disease. J Clin Gastroenterol. 2013;47(3):195–204. doi:10.1097/MCG.0b013e31827458f9.
Watson G, O’Hara J, Carding P, et al. TOPPITS: trial of proton pump inhibitors in throat symptoms. Study protocol for a randomised controlled trial. Trials. 2016;17(1):175. doi:10.1186/s13063-016-1267-7.
Vaezi MF, Lopez R, Hicks D, Abelson T, et al. What is the optimal initial therapy duration for patients with suspected GERD-related laryngitis? Gastroenterology. 2006;130:A140.
Sahin M, Vardar R, Ersin S, Kirazli T, Ogut MF, Akyildiz NS, Bor S. The effect of antireflux surgery on laryngeal symptoms, findings and voice parameters. Eur Arch Otorhinolaryngol. 2015;272(11):3375–83.
So JBY, Zeitels SM, Rattner DW. Outcome of atypical symptoms attributed to gastresophageal reflux disease treated by laparoscopic fundoplication. Surgery. 1998;124:28–32.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Naftali, T. (2018). Supraesophageal Reflux Disease (SERD). In: Bardan, E., Shaker, R. (eds) Gastrointestinal Motility Disorders . Springer, Cham. https://doi.org/10.1007/978-3-319-59352-4_14
Download citation
DOI: https://doi.org/10.1007/978-3-319-59352-4_14
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-59350-0
Online ISBN: 978-3-319-59352-4
eBook Packages: MedicineMedicine (R0)