Non Acid GERD respiratory disorders.doc

Non-acid gastroesophageal reflux and respiratory disorders: a literature review Ohio Journal of Science, The, June, 2006 by Hayat Mousa, Frederick W. Woodley ABSTRACT. Recent technological advances that now permit us to detect gastroesophageal reflux (GER), independent of pH, have sparked a fury of interest in non-acid GER as a potential culprit in respiratory disorders. Application of combined esophageal pH and multichannel intraluminal impedance (MII) monitoring to the study and diagnosis of GER disease (GERD) demonstrated non-acid GER to be far more frequent (in infants, children, and adults alike) than previously recognized. The following report is a review of the current literature that describes non-acid GER or that temporally associates non-acid GER with respiratory disorders. INTRODUCTION Persistent Respiratory Symptoms Respiratory symptoms associated with GER have been previously described (Harding and others 1999; Wenzl and others 1999; Wenzl and others 2001; Rosen and Nurko 2004; Blondeau and others 2004). While relief of respiratory symptoms for some patients is achieved through acid suppression therapies (Meier and others 1994; Harding and others 1996; Teichtahl and others 1996), many patients continue to have respiratory symptoms that could be attributed to GER (Meier and others 1994; Harding and others 1996; Gustafsson and others 1992; Kiljander and others 1999; Garrigues and others 2003; Bowrey and others 2000). These data, in conjunction with previous studies that indicate that anti-reflux surgery produces dramatic relief of respiratory symptoms (Kennedy 1962; Overholt and Voorhees 1966; Davis and Fiuzat 1967; Skinner and Belsey 1967; Urschel and Paulson 1967; Babb and others 1970; Lomasney 1977; Henderson and Woolfe 1978; Pellegrini and others 1979), support a possible role for non-acid reflux in the persistence of respiratory symptoms following acid suppression therapy in children with acid GER. One of the first studies linking non-acid GER wit