Association Between Gastroesophageal Reflux Disease and Chronic Respiratory Symptoms: A Systematic Review of Recent Clinical Evidence and Therapeutic Implications

Abstract

Gastroesophageal reflux disease (GERD) is increasingly recognized as a potential contributor to chronic respiratory symptoms, yet its role in the pathogenesis and management of such conditions remains underexplored. This systematic review aimed to evaluate the association between GERD and respiratory manifestations including chronic cough, asthma, chronic rhinosinusitis, and chronic obstructive pulmonary disease (COPD). A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Embase for studies published between January 2020 and April 2025. Six eligible studies, including randomized controlled trials and prospective observational studies, were analyzed. The findings demonstrate a consistent relationship between GERD and respiratory symptoms, with acid-suppressive therapies - particularly proton pump inhibitors (PPIs) and potassium-competitive acid blockers (P-CABs) - leading to symptomatic improvement in several patient populations. Non-pharmacological interventions such as diaphragmatic breathing also showed clinical benefit in GERD-induced chronic cough. Pediatric evidence, though limited, supported the role of GERD management in improving asthma control. Risk of bias across studies was generally low to moderate. While causality cannot be definitively established, the cumulative evidence highlights the importance of considering GERD in patients with refractory respiratory complaints. Integrating GERD assessment and treatment into respiratory care may enhance patient outcomes and reduce healthcare burden. Copyright © 2025, Ahmed et al.