Extraesophageal presentations of gastroesophageal reflux disease: the case for aggressive diagnosis and treatment
JOEL E. RICHTER, MD
Dr. Richter is chairman of the Department, of Gastroenterology at the Cleveland Clinic, Foundation, specializing in esophageal diseases, with particular interest in GERD, achalasia, and noncardiac chest pain. He was recently, president of the American College of, Gastroenterology.
Gastroesophageal reflux disease (GERD) has a number of extraesophageal presentations, including noncardiac chest pain, asthma, and laryngitis. Although 24-hour esophageal pH monitoring is the best test to diagnose GERD, an empiric approach to treatment, using an aggressive acid suppression regimen such as a proton-pump inhibitor, may be more cost-effective.