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Updated: Jul 11, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Recurrent pneumonia from severe nonacid reflux: a case report and discussion
Ashish Malhotra1, James W Freston, Maria Soriano
1Department of Medicine, University of Connecticut Health Center, Farmington, USA. ashmalhotra@yahoo.com
Abstract:
The role of acid in the pathophysiology of gastroesophageal reflux disease (GERD) is extensively studied and well accepted. The role of nonacid reflux is poorly understood and its diagnosis is elusive. It has been postulated that the nonacid component of refluxate may play a significant role in causing esophageal mucosal damage and extra esophageal manifestations of GERD. We report a patient with severe nonacid reflux causing recurrent pneumonias and choking episodes resulting in serious morbidity and extensive utilization of health care resources. The diagnosis was established by combined intraluminal pH-impedance testing. Medical management with prokinetic agents and proton pump inhibitors failed. The patient's symptoms were ultimately controlled by a permanent jejunostomy. This patient illustrates the combined challenges in the diagnosis and treatment of nonacid reflux, particularly as it relates to larnyngopharyngeal and pulmonary manifestations.
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