Open AccessExtraoesophageal symptoms of gastroesophageal reflux disease: laryngopharyngeal reflux in focus
Author(s) -
Д. И. Трухан,
Natalia A. Chusova,
О. В. Дрокина
Publication year - 2020
Publication title -
consilium medicum
Language(s) - English
Resource type - Journals
eISSN - 2542-2170
pISSN - 2075-1753
DOI - 10.26442/20751753.2020.12.200559
Subject(s) - laryngopharyngeal reflux , gerd , medicine , reflux , proton pump inhibitor , gastroenterology , disease , pepsin , antacid , regurgitation (circulation) , chronic cough , rabeprazole , asthma , biochemistry , chemistry , enzyme
Gastroesophageal reflux disease (GERD) ranks first among gastroenterological diseases in terms of prevalence. GERD can also manifest with extraesophageal (atypical) symptoms, which include: cardiac, pulmonary, otorhinolaryngological and dental symptoms. In some cases, extraesophageal manifestations can come to the fore in the clinical picture. Moreover, in 25% of cases, GERD clinically occurs only with extraesophageal symptoms, which fits into one of the main features of modern real clinical practice – various diseases are increasingly losing their mononosological character, acquiring the status of comorbidity and multimorbidity. The presence of extraesophageal symptoms in patients with GERD is due to extraesophageal (or, more precisely, gastroesophagolaryngopharyngeal) reflux, which is referred to in the international medical literature as laryngopharyngeal reflux (LFR). Currently, LFR is considered as a condition of inflammation of the mucous membrane of the upper digestive and respiratory tracts associated with direct and indirect (reflex) effects of gastroduodenal refluctate, which can cause morphological changes in the mucous membrane. Over the past decade, two approaches to the treatment of LFR have emerged. The first approach involves the use of proton pump inhibitors (PPIs) as monotherapy along with dietary and lifestyle modification. The second comprehensive approach to LFR therapy in-volves dual therapy (PPI + alginate/antacid or PPI + prokinetic) or triple therapy (PPI + alginate/antacid + prokinetic). In this review, both approaches to the tre-atment of LFR are considered, and the possibilities of alginates in the treatment of LFR are considered.