Gastroesophageal Reflux Disease with Laryngopharyngeal Manifestation in Korea

Background/Aims: Globus pharyngeus and hoarseness are common extraesophageal manifestations in patients with gastroesophageal reflux disease. The aim of this study was to evaluate the clinical characteristics, laryngoscopic findings, endoscopic findings, and response to proton pump inhibitors in patients presenting laryngeal symptoms suspected to be caused by GERD. Methodology: We retrospectively reviewed the medical records of 160 patients that presented with globus and/or hoarseness and underwent acid suppression therapy under the impression of GERD from May 2003 to April 2009. Results: Sixty patients (37.5%) reported classical GERD symptoms such as heartburn and/or acid regurgitation. Sixty nine percent (69%) of patients (95/138) showed abnormal laryngoscopic findings such as laryngeal edema/hyperemia, vocal cord swelling/hyperemia, arytenoids swelling/hyperemia, vocal cord nodule, vocal cord polyp, postglottic swelling/hyperemia, etc. Endoscopically, 41.9% (39/93) showed normal endoscopic findings and 49.5% (46/93) showed minimal changes. 8.6% (8/93) of patients showed erosive reflux disease. Therapeutic response was not significantly different among patients treated with standard dose PPIs (44/58, 75.9%), half dose PPIs (17/22, 77.3%), or revaprazan (18/21, 85.7%). Conclusions: Among patients with globus pharyngeus and/or hoarseness and suspected GERD, only 37.5% reported classical symptoms of GERD such as heartburn and/or acid regurgitation, 69% showed abnormal laryngoscopic findings, 58.1% showed abnormal endoscopic findings, and 80% showed therapeutic response to acid suppression therapy.