atypical GERDAn atypical presentation of GERD/GORD (gastro-esophageal/gastro-oesophageal reflux disease) that affects up to 30% of patients with classic GERD/GORD.
• Lungs—asthma, cough, chronic bronchitis, pulmonary fibrosis, pneumonia.
• ENT—laryngitis, sinusitis, hoarseness, vocal nodules, globus hystericus.
• Others—noncardiac chest pain, dental erosion, hiccups.
Diagnosis of exclusion; history of severe chest pain (postprandial or nocturnal); endoscopic esophagitis, < 50% of patients; esophageal pH monitoring (85% sensitivity); test of therapy.
Atypical GERD/GORD requires longer treatment than classic GERD/GORD and is less responsive to therapy, requiring high-dose proton pump inhibitor therapy for 12 weeks; nonresponders may need fundoplication.
atypical GERDInternal medicine An atypical presentation of GERD which affects up to 30% of Pts with classic GERD Clinical
1. Lungs–asthma, cough, chronic bronchitis, pulmonary fibrosis, pneumonia;.
2. ENT–laryngitis, sinusitis, hoarseness, vocal nodules, globus hystericus;.
3. Others–noncardiac chest pain, dental erosion, hiccups Diagnosis Dx of exclusion; Hx of severe chest pain–postprandial or nocturnal; endoscopic esophagitis, < 50% of Pts; esophageal pH monitoring–85% sensitivity; test of therapy Management Unlike classic GERD, atypical GERD requires longer treatment, is less responsive to therapy; high-dose proton pump inhibitor therapy for 12 wks; nonresponders may require fundoplication. See GERD, Noncardiac chest pain.