Management of respiratory symptoms associated with gastroesophageal reflux disease

An association between gastroesophageal reflux and respiratory symptoms has been postulated to exist for some time. Several theories support a pathophysiologic relationship. Effective treatment of gastroesophageal reflux-related respiratory symptoms is not standardized. Modification of lifestyle may be beneficial, but the majority of patients should receive proton pump inhibitor therapy to suppress acid secretion. Treatment failures should be assessed for patient non-compliance, failure to make correct diagnosis, failure to recognize co-existing disease, and failure to treat adequately. If acid suppression is inadequate and acid reflux events persist even with additional acid suppression, patients should be considered for an antireflux operation with expected long-term clinical improvement and decreased medication requirements. Because laparoscopic techniques offer the benefit of antireflux surgery with reduced morbidity, this modality should be considered the current treatment of choice.