Gastroesophageal Reflux and Respiratory Diseases

Abstract

Gastroesophageal reflux (GER) is considered to be a physiological event in most cases, but should be differentiated from disease caused by GER, where symptoms or complications are present. Direct contact between gastric juice and its components with the airway may cause damage to these structures, which can lead to association with multiple respiratory diseases (asthma, chronic cough, aspiration disorders, apnea, subglottic stenosis, etc.); however, in most of them causality has not been confirmed. The diagnosis of disease caused by GER may be complex when symptoms are subtle or prolonged, and should be suspected in children with compatible symptoms, feeding problems, non-explained airway problems or lack of response to treatment. Complementary tests can be useful, but should be reserved when there is a specific clinical question. Proton pump inhibitors are considered first choice for suppression of acid effect and to treat erosive esophagitis. Surgery can be considered in situations such as failure of optimal medical therapy, though there is limited evidence in children.