Diagnosis of extraesophageal manifestations of GERD: an interdisciplinary approach

Background. Current concepts define gastroesophageal reflux disease as a chronic, recurrent condition, characterised by impaired upper gastrointestinal motility, gastroesophageal junction dysfunction, and pathological gastroesophageal reflux. This contributes to the development of clinical manifestations, as well as inflammatory, dystrophic, erosive, ulcerative, and metaplastic changes of the distal esophageal mucosa due to exposure to aggressive refluxate components. Clinical manifestations associated with gastroesophageal reflux disease can be subdivided into esophageal (heartburn, acid regurgitation) and extraesophageal. Extraesophageal manifestations of gastroesophageal reflux disease represent one of the most complex clinical challenges. The high prevalence of gastroesophageal reflux disease in the population, due to its multifactorial nature, its clinical variability, and absence of a universally accepted diagnostic gold standard often increase the time to diagnosis and the initiation of rational therapy. Managing patients with extraesophageal manifestations is particularly challenging, as their lack of specificity often contributes to misdiagnosis as other conditions unrelated to pathological reflux. Due to its tight anatomical and physiological relationship, among the wide spectrum of extraesophageal manifestations of gastroesophageal reflux disease, otorhinolaryngological and dental ones are the most frequently reported. A multidisciplinary approach, based on the collaboration between a gastroenterologist, otolaryngologist, and dentist, is essential in the management of these patients and improves diagnostic and treatment management.

Conclusion. This article summarizes and systematizes data on the mechanisms, clinical manifestations, and the capabilities of modern diagnosis of otorhinolaryngologic and dental manifestations of gastroesophageal reflux disease.

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