Different clinical symptom patterns in patients with reflux micro-aspiration

Area of Science:

• Gastroenterology
• Pulmonology
• Otolaryngology

Background:

• Pulmonary manifestations of gastro-oesophageal reflux disease (GORD) are recognized.
• Limited data exists on presenting symptoms of patients with confirmed reflux micro-aspiration.

Purpose of the Study:

• To report the symptoms and presenting patterns of a large cohort of patients with confirmed reflux micro-aspiration.

Main Methods:

• Data from a prospectively populated database of patients with severe, refractory, or atypical reflux were analyzed.
• Patients with confirmed reflux micro-aspiration on scintigraphy were included.
• A separate group with evidence of proximal reflux to the pharynx was also studied.

Main Results:

• 243 patients with confirmed reflux micro-aspiration were analyzed (mean age 59, 33% males).
• Common symptoms included regurgitation (72%), cough (67%), heartburn (66%), throat clearing (65%), and dysphonia (53%).
• Cluster analysis revealed two symptom groupings: proximal volume reflux and motility/IBS-like symptoms.

Conclusions:

• A combination of typical GORD symptoms (heartburn, regurgitation) and respiratory/upper aerodigestive complaints (cough, throat clearing, voice change) suggests reflux micro-aspiration.
• Prompt consideration of reflux micro-aspiration is warranted in such cases.