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[Gastroesophageal reflux: a pulmonologist's viewpoint].
Georges Khayat1, Paul Henri Torbey, Zeina Aoun-Bacha
1Service de Pneumologie, Hôtel-Dieu de France & Faculté de Médecine, Université Saint-Joseph, Beyrouth, Liban. gck@dm.net.lb
Summary
Gastroesophageal reflux (GER) is common and can cause various symptoms. Investigating GER is crucial, especially for pulmonologists, as it may link to respiratory issues and indicate disease severity.
Area of Science:
- Gastroenterology and Pulmonology
- Physiology
Context:
- Gastroesophageal reflux (GER) presents with diverse symptoms, including digestive, extra-digestive, respiratory, and otolaryngologic manifestations.
- GER is frequently implicated in chronic pulmonary disorders, necessitating a focused review for pulmonologists.
- Understanding GER's pathogenesis, clinical signs, complications, and treatment is vital for managing related respiratory conditions.
Purpose:
- To review the pathogenesis, clinical signs, complications, and treatment of GER.
- To highlight the specific relevance of GER to the field of pulmonology.
- To provide insights into diagnosing and managing GER, particularly when respiratory symptoms are present.
Summary:
- GER is a normal post-meal event, often caused by transient lower esophageal sphincter relaxations (tLESR) or reduced LES function.
- Extra-digestive symptoms arise from vagal nerve stimulation due to esophageal acid exposure or micro-aspiration into airways.
- Diagnosing GER's role in respiratory symptoms can be challenging; a trial of proton pump inhibitors and gastroesophageal assessment are recommended.
Impact:
- This review emphasizes the importance of considering GER in patients with unexplained respiratory symptoms.
- It guides pulmonologists in evaluating and managing GER, potentially improving patient outcomes.
- Recognizing GER's link to pulmonary issues underscores the need for multidisciplinary approaches in patient care.