Esophageal function tests are not helpful in symptoms suspicious of extraesophageal reflux - a prospective study in...

Symptoms suspicious of extraesophageal reflux (SSEER) include globus, chronic cough, mucous obstruction and hoarseness. Reports of conventional esophageal function tests and measurement of extraesophageal reflux (EER) in these patients are spare providing conflicting results.

In a prospective study we evaluated 60 patients with SSEER by esophageal function tests (esophageal manometry, combined 24 h pH - metry - impedance and oropharyngeal pH measurement, Dx - pH measurement) and esophagogastroduodenoscopy (EGD). The patients were stratified into 2 groups according to their accompanying reflux symptoms. Group 1, n = 23, comprised patients with SSEER solely and group 2, n = 37 patients with SSEER and reflux symptoms. The patients were compared to patients with reflux symptoms solely (group 3, n = 14).

There were no significant differences between the groups according to age, sex and BMI. Patients with SSEER and reflux symptoms (group 2) showed significantly increased proportion of pathological acid reflux, de Meester Score, pH < 4 overall and in upright positon and hypotensive lower esophageal sphincter pressure compared to patients with SSEER solely (group 1) but no significant difference to patients with reflux symptoms solely (group 3). All the other parameters of esophageal testing including non-acid reflux and EER were not significantly different between the three groups.

The results of the present study do not support a causal link between SSEER and esophageal motility disorders, acid or non-acid reflux and EER as measured by conventional esophageal function tests and oropharyngeal pH measurement.