Gastroesophageal reflux and upper airway diseases

GER can have important impacts on the upper airway passages, and in turn, upper airway obstruction can certainly aggravate reflux. This relationship should be considered in the newborn or young infant, faced with a sudden life-threatening event, and in the older child or adult presenting with chronic head and neck complaints, either unexplained or unresponsive to adequate medical therapy. A causal relationship may be difficult to establish, based first on clinical expertise as a guideline, on laboratory tests, among which pharyngeal pH monitoring could be promising, and on response to medical antireflux therapy. A better understanding of the significance of high levels of reflux and defective acid clearance, as well as a more precise knowledge of the maturation and functioning of upper airway protective mechanisms, would open the way to more accurate diagnostic procedures, to a more reliable definition of the abnormal, and to greater efficiency in the management of these patients.