Características clínicas, endoscópicas y manométricas de pacientes con reflujo gastroesofágico (RCE) y manifestaciones atípicas.

Objectives: To investigate the prevalence of GERD (gastroesophagic reflux disease) as well as the clinical, endoscopic and manometric characteristics of patients with atypical symptoms. Methods: Fifty-seven adult patients with otolaryngeal manifestations, asthma or non-cardiac chest pain were included in the study. The prevalence of GERD by means of 24-hour esophageal pH monitoring and the demographic, clinical, endoscopic and manometric characteristics of the patients with or without GERD were evaluated. GERD patients were randomly assigned to receive cisaprida and pantoprazole as a therapeutic test. Symptom response was evaluated using the Visual Analogue Scale. Results: Of the 57 patients studied, 34 had GERD (60%). The 95% confidence interval ranged from 48 to 72%. There was no statistical difference between both groups regarding gender, age or evolution time of symptoms. Cough was more frequent in subjects with GERD (75 vs. 25%, p < 0.05) and dysphagia was more common in the patients without GERD (78 vs. 22%. p < 0.05). Nevertheless, cough was present in only 53% of the patients with GERD and dysphagia was present in only 30% of patients without GERD. There was no difference between the two groups with respect to the other evaluated atypical symptoms. Patients with GERD showed a higher incidence of esophageal laryngitis, hiatal hernia, Barret mucosa, hypotonic LES and abnormal peristalsis than those without GERD. Patients suffering laryngitis had greater proximal acid exposure time and symptoms index than those without. After completion of treatment, 74% of patients showed partial or complete response. Conclusions: The prevalence of GERD in our population was 60% in patients with atypical symptoms. There is neither a definite demographic nor a clinical profile that permit us to distinguish between patients with or without GERD. Patients with laryngitis showed more intense proximal reflux than those without laryngitis. Erosive esophagitis is not common in those patients with GERD. Finally, the response to treatment in the majority of the patients permits us to establish a cause-and-effect relationship. [ABSTRACT FROM AUTHOR]