0
September 25, 1996, Vol 276, No. 12 >
ARTICLE | September 25, 1996

Gastroesophageal Reflux Disease FREE

Peter J. Kahrilas, MD
[+] Author Affiliations

Reprints: Peter J. Kahrilas, MD, Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Medical School, Passavant Pavilion, Suite 746, 303 E Superior St, Chicago, IL 60611.


JAMA. 1996;276(12):983-988. doi:10.1001/jama.1996.03540120061035
Text Size: A A A
Published online
Article
References

Objective.  —To review the management of gastroesophageal reflux disease (GERD) in adults with esophageal complications (esophagitis, stricture, adenocarcinoma, or Barrett metaplasia) or extraesophageal complications (otolaryngological manifestations and asthma).

Data Sources.  —Peer-reviewed publications located via MEDLINE or crosscitation.

Study Selection.  —Emphasis was placed on new developments in diagnosis and therapeutics. Thus, fewer than 10% of identified citations are discussed.

Data Extraction.  —Controlled therapeutic trials were emphasized. The validity of pathophysiological observations and uncontrolled trials were critiqued by the author.

Data Synthesis.  —Esophagitis is typically a chronic, recurring disorder treated with long-term antisecretory therapy, titrated to disease severity. Laparascopic antireflux surgery is an alternative strategy, but neither long-term efficacy data nor an appropriate controlled trial comparing it with proton pump inhibitor therapy exists. The main risk of esophagitis is adenocarcinoma arising from Barrett metaplasia, the incidence of which is increasing. Strong evidence suggests that both reflux-induced asthma and otolaryngological complications (subglottic stenosis, laryngitis, pharyngitis, or cancer) can occur without esophagitis. While the otolaryngological manifestations usually respond to antisecretory medications, reflux-induced asthma responds convincingly only to antireflux surgery.

Conclusions.  —Although esophagitis and GERD symptoms predictably respond to antisecretory medicines, the risk of adenocarcinoma from Barrett metaplasia dictates that if heartburn is refractory to treatment, chronic (>5 years), or accompanied by dysphagia, odynophagia, or bleeding, it should be evaluated by endoscopy. Thereafter, patients with Barrett metaplasia require surveillance endoscopy to control the cancer risk. Reflux-induced asthma remains a vexing problem in the absence of either medical therapy of proven efficacy or a reliable mechanism of prospectively identifying affected patients.

REFERENCES

1 +
Winkelstein A.  Peptic esophagitis: a new clinical entity . JAMA . 1935;;104:906-909.
2 +
Allison PR.  Peptic ulcer of the esophagus . J Thorac Surg . 1946;;15:308-317.
3 +
Nebel OT, Fornes MF, Castell DO.  Symptomatic gastroesophageal reflux: incidence and precipitating factors . Am J Dig Dis . 1976;;21:953-956.
4 +
Hirschowitz BI.  A critical analysis, with appropriate controls, of gastric acid and pepsin secretion in clinical esophagitis . Gastroenterology . 1991;;101:1149-1158.
5 +
Orlando RC.  Esophageal epithelial defenses against acid injury . Am J Gastroenterol . 1994;;89:S48-S52.
6 +
Tibbling L.  Epidemiology of gastro-oesophageal reflux disease . Scand J Gastroenterol . 1984;;19( (suppl 106) ):14-18.
7 +
Sontag SJ.  Gastroesophageal reflux disease . Aliment Pharmacol Ther . 1993;;7:293-312.
8 +
Bell NJV, Hunt RH.  Role of gastric acid suppression in the treatment of gastro-oesophageal reflux disease . Gut . 1992;;33:118-124.
9 +
Richter JE, Long JF.  Cisapride for gastroesophageal reflux disease: a placebo-controlled, double blind study . Am J Gastroenterol . 1995;;90:423-430.
10 +
Dorsch E, Jones J, Padgett C, Jennings D, Greski P, Lansoprazole Study Group.  Lansoprazole heals moderate to severe reflux esophagitis . Am J Gastroenterol . 1991;;86( (suppl 9) ):1294.
11 +
Sontag SJ.  The medical management of reflux esophagitis; role of antacids and acid inhibition . Gastroenterol Clin North Am . 1990;;19:683-712.
12 +
Hatlebakk JG, Berstad A, Carling L, et al.  Lansoprazole versus omeprazole in short-term treatment of reflux esophagitis: results of a Scandinavian multicentre trial . Scand J Gastroenterol . 1993;;28:224-228.
13 +
Feldman M, Harford WV, Fisher RS, et al.  Treatment of reflux esophagitis resistant to H2receptor antagonists with lansoprazole, a new H+/ K*-ATPase inhibitor: a controlled, double-blind study . Am J Gastroenterol . 1993;;88:1212-1217.
14 +
Klinkenberg-Knol EC, Festen HPM, Jansen JBMJ, et al.  Long-term treatment with omeprazole for refractory reflux esophagitis: efficacy and safety . Ann Intern Med . 1994;;121:161-167.
15 +
Miller LG, Jankovic J.  Metoclopramide-induced movement disorders . Arch Intern Med . 1989;;149:2486-2492.
16 +
Galmiche JP, Brandsätter, Evreux M, Hentschel E.  Combined therapy with cisapride and cimetidine in severe oesophagitis: a double blind controlled trial . Gut . 1988;;29:675-681.
17 +
Hetzel DJ, Dent J, Reed WD, et al.  Healing and relapse of severe peptic esophagitis after treatment with omeprazole . Gastroenterology . 1988;;95:903-912.
18 +
Dent J, Yeomans ND, Mackinnon M, et al.  Omeprazole v ranitidine for prevention of relapse in reflux oesophagitis: a controlled double blind trial of their efficacy and safety . Gut . 1994;;35:590-598.
19 +
Vigneri S, Termini R, Leandro G, et al.  A comparison of five maintenance therapies for reflux esophagitis . N Engl J Med . 1995;;333:1106-1110.
20 +
Robinson M, Lanza F, Avner D, Haber M.  Effective maintenance treatment of reflux esophagitis with low-dose lansoprazole: a randomized double blind placebo-controlled trial . Ann Intern Med . 1996;; 124:859-867.
21 +
Freston JW.  Omeprazole, hypergastrinemia, and gastric carcinoid tumors . Ann Intern Med . 1994;;121:232-234.
22 +
Kuipers EJ, Lundell L, Klinkenberg-Knol EC, et al.  Atrophic gastritis and Helicobacter pylori infection in patients with reflux esophagitis treated with omeprazole or fundoplication . N Engl J Med . 1996;;334:1018-1022.
23 +
Peters JH, DeMeester TR. Minimally Invasive Surgery of the Foregut . St Louis, Mo: Quality Medical Publishing; 1994;.
24 +
Hinder RA, Filipi CJ, Wetscher G, DeMeester TR, Perdikis G.  Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease . Ann Surg . 1994;;220:472-481.
25 +
Trus TL, Laycock WS, Branum G, Waring JP, Mauren S, Hunter JG.  Intermediate follow-up of laparoscopic antireflux surgery . Am J Surg . 1996;;171:32-35.
26 +
Spechler SJ, Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group.  Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans . N Engl J Med . 1992;;326:786-792.
27 +
Cameron AJ, Higgins JA.  Linear gastric erosion, a lesion associated with large diaphragmatic hernia and chronic blood loss anemia . Gastroenterology . 1986;;91:338-342.
28 +
Wesdorp IC, Bartelsman JF, den Hartog Jager FC, Huibregtse K, Tytgat GN.  Results of conservative treatment of benign esophageal stricture: a follow-up study in 100 patients . Gastroenterology . 1982;;82:487-493.
29 +
Patterson DJ, Graham DY, Smith JL, et al.  Natural history of benign esophageal stricture treated by dilatation . Gastroenterology . 1983;;85:346-350.
30 +
Mercer CD, Hill LD.  Surgical management of peptic esophageal stricture: twenty-year experience . J Thorac Cardiovasc Surg . 1986;;91:371-378.
31 +
Marks RD, Richter JE, Rizzo J, et al.  Omeprazole versus H2-receptor antagonists in treating patients with peptic stricture and esophagitis . Gastroenterology . 1994;;106:907-915.
32 +
Morson BC, Sobin LH, Grundmann E, Johansen A, Nagayo T, Serck-Hanssen A.  Pre-cancerous conditions and epithelial dysplasia in the stomach . J Clin Pathol . 1980;;33:711-721.
33 +
Sampliner RE.  Effect of up to 3 years of highdose lansoprazole on Barrett's esophagus . Am J Gastroenterol . 1994;;89:1844-1848.
34 +
Spechler SJ, Goyal RK.  Barrett's esophagus . N Engl J Med . 1986;;315:362-371.
35 +
Cameron AJ, Ott BJ, Payne WS.  The incidence of adenocarcinoma in columnar-lined (Barrett's) esophagus . N Engl J Med . 1985;;313:857-859.
36 +
Spechler SJ, Zeroogian JM, Antonioli DA, Wang HH, Goyal RJ.  Prevalence of metaplasia at the gastrooesophageal junction . Lancet . 1994;;344:1533-1536.
37 +
Schnell TG, Sontag SJ, Chejfec G.  Adenocarcinomas arising in tongues or short segments of Barrett's esophagus . Dig Dis Sci . 1992;;37:137-143.
38 +
Blot WJ, Devesa SS, Kneller RW, Fraumeni JF.  Rising incidence of adenocarcinoma of the esophagus and gastric cardia . JAMA . 1991;;265:1287-1289.
39 +
Blot WJ, Devesa SS, Fraumeni JF.  Continuing climb in rates of esophageal adenocarcinoma: an update . JAMA . 1993;;270:1320.
40 +
Clark GWB, Smyrk TC, Burdiles P, et al.  Is Barrett's metaplasia the source of adenocarcinomas of the cardia? Arch Surg . 1994;;129:609-614.
41 +
Sampliner RE, Jaffe P.  Malignant degeneration of Barrett's esophagus; the role of laser ablation and photodynamic therapy . Dis Esophagus . 1995;;8:104-108.
42 +
Fennerty MB, Sampliner RE, Garewal HS.  Review article: Barrett's esophagus—cancer risk, biology and therapeutic management . Aliment Pharmacol Ther . 1993;;7:339-345.
43 +
Dent J, Bremner CG, Collen MJ, Haggitt RC, Spechler SJ. Barrett's Oesophagus: Working Party Reports of the Ninth World Congresses of Gastroenterology . Melbourne, Australia: Blackwell Scientific Publications; 1990;:17-26.
44 +
Ing AJ, Ngu MC, Breslin ABX.  The pathogenesis of chronic persistent cough associated with gastroesophageal reflux . Am J Respir Crit Care Med . 1994;;149:160-167.
45 +
Schroeder PL, Filler SJ, Ramierez B, Lazarchik DA, Vaezi MF, Richter JE.  Dental erosions and acid reflux disease . Ann Intern Med . 1995;;122:809-815.
46 +
Sontag SJ, O'Connell S, Khandelwal S, et al.  Most asthmatics have gastroesophageal reflux with or without bronchodilator therapy . Gastroenterology . 1990;;99:613-620.
47 +
Harding SM, Richter JE, Guzzo MR, Schan CA, Alexander RW, Bradley LA.  Asthma and gastroesophageal reflux: acid suppressive therapy improves asthma outcome . Am J Med . 1996;;100:395-405.
48 +
Mansfield LE, Stein MR.  Gastroesophageal reflux and asthma: a possible reflex mechanism . Ann Allergy . 1978;;41:224-226.
49 +
Tuchman DN, Boyle JT, Pack AI, et al.  Comparison of airway responses following tracheal or esophageal acidification in the cat . Gastroenterology . 1984;;87:872-881.
50 +
Crausaz FM, Favez G.  Aspiration of solid food particles into the lungs of patients with gastroesophageal reflux and chronic bronchial disease . Chest . 1988;;93:376-378.
51 +
Larrain A, Carrasco E, Galleguillos F, Sepulveda R, Pope CE.  Medical and surgical treatment of nonallergic asthma associated with gastroesophageal reflux . Chest . 1991;;99:1330-1335.
52 +
Jacob P, Kahrilas PJ, Herzon G.  Proximal esophageal pH-metry in patients with 'reflux laryngitis.' Gastroenterology . 1991;;100:305-310.
53 +
Koufman JA.  The otolaryngologic manifestations of gastroesophageal reflux disease . Laryngoscope . 1991;;10( (suppl 53) ):1-78.
54 +
Shaker R, Milbrath M, Ren J, et al.  Esophagopharyngeal distribution of refluxed gastric acid in patients with reflux laryngitis . Gastroenterology . 1995;;109:1575-1572.
55 +
Cote DN, Miller RH.  The association of gastroesophageal reflux and otolaryngologic disorders . Compr Ther . 1995;;21:80-84.
56 +
Gaynor EB.  Gastroesophageal reflux as an etiologic factor in laryngeal complications of intubation . Laryngoscope . 1988;;98:972-979.
57 +
Cherry J, Margulies SI.  Contact ulcer of the larynx . Laryngoscope . 1968;;78:1937-1940.
58 +
Kambic V, Radsel Z.  Acid posterior laryngitis, aetiology, histology, diagnosis and treatment . J Laryngol Otol . 1984;;98:1237-1240.
59 +
Kamel PL, Hanson D, Kahrilas PJ.  Prospective trial of omeprazole in the treatment of posterior laryngitis . Am J Med . 1994;;96:321-326.
60 +
Hanson DG, Kamel PL, Kahrilas PJ.  Outcomes of anti-reflux therapy in the treatment of chronic laryngitis . Ann Otol Rhinol Laryngol . 1995;;104:550-555.
61 +
Wydner EL, Stellman SD.  Comparative epidemiology of tobacco-related cancers . Cancer Res . 1977;;37:4608-4622.
62 +
Olsen NR.  Effects of stomach acid on the larynx . Proc Am Laryngol Assoc . 1983;;104:108-112.
63 +
Morrison MD.  Is chronic gastroesophageal reflux a causative factor in glottic carcinoma? Otolaryngol Head Neck Surg . 1988;;99:370-373.
64 +
Ward PH, Hanson DG.  Reflux as an etiologic factor of carcinoma of the laryngopharynx . Laryngoscope . 1988;;98:1195-1199.
65 +
Kahrilas PJ, Clouse RE, Hogan WJ.  American Gastroenterological Association technical review on the clinical use of esophageal manometry . Gastroenterology . 1994;;107:1865-1884.
66 +
Kahrilas PJ, Quigley EMM.  Clinical esophageal pH monitoring, a technical review for practice guideline development . Gastroenterology . 1996;;110:1982-1996.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Winkelstein A.  Peptic esophagitis: a new clinical entity . JAMA . 1935;;104:906-909.
2 +
Allison PR.  Peptic ulcer of the esophagus . J Thorac Surg . 1946;;15:308-317.
3 +
Nebel OT, Fornes MF, Castell DO.  Symptomatic gastroesophageal reflux: incidence and precipitating factors . Am J Dig Dis . 1976;;21:953-956.
4 +
Hirschowitz BI.  A critical analysis, with appropriate controls, of gastric acid and pepsin secretion in clinical esophagitis . Gastroenterology . 1991;;101:1149-1158.
5 +
Orlando RC.  Esophageal epithelial defenses against acid injury . Am J Gastroenterol . 1994;;89:S48-S52.
6 +
Tibbling L.  Epidemiology of gastro-oesophageal reflux disease . Scand J Gastroenterol . 1984;;19( (suppl 106) ):14-18.
7 +
Sontag SJ.  Gastroesophageal reflux disease . Aliment Pharmacol Ther . 1993;;7:293-312.
8 +
Bell NJV, Hunt RH.  Role of gastric acid suppression in the treatment of gastro-oesophageal reflux disease . Gut . 1992;;33:118-124.
9 +
Richter JE, Long JF.  Cisapride for gastroesophageal reflux disease: a placebo-controlled, double blind study . Am J Gastroenterol . 1995;;90:423-430.
10 +
Dorsch E, Jones J, Padgett C, Jennings D, Greski P, Lansoprazole Study Group.  Lansoprazole heals moderate to severe reflux esophagitis . Am J Gastroenterol . 1991;;86( (suppl 9) ):1294.
11 +
Sontag SJ.  The medical management of reflux esophagitis; role of antacids and acid inhibition . Gastroenterol Clin North Am . 1990;;19:683-712.
12 +
Hatlebakk JG, Berstad A, Carling L, et al.  Lansoprazole versus omeprazole in short-term treatment of reflux esophagitis: results of a Scandinavian multicentre trial . Scand J Gastroenterol . 1993;;28:224-228.
13 +
Feldman M, Harford WV, Fisher RS, et al.  Treatment of reflux esophagitis resistant to H2receptor antagonists with lansoprazole, a new H+/ K*-ATPase inhibitor: a controlled, double-blind study . Am J Gastroenterol . 1993;;88:1212-1217.
14 +
Klinkenberg-Knol EC, Festen HPM, Jansen JBMJ, et al.  Long-term treatment with omeprazole for refractory reflux esophagitis: efficacy and safety . Ann Intern Med . 1994;;121:161-167.
15 +
Miller LG, Jankovic J.  Metoclopramide-induced movement disorders . Arch Intern Med . 1989;;149:2486-2492.
16 +
Galmiche JP, Brandsätter, Evreux M, Hentschel E.  Combined therapy with cisapride and cimetidine in severe oesophagitis: a double blind controlled trial . Gut . 1988;;29:675-681.
17 +
Hetzel DJ, Dent J, Reed WD, et al.  Healing and relapse of severe peptic esophagitis after treatment with omeprazole . Gastroenterology . 1988;;95:903-912.
18 +
Dent J, Yeomans ND, Mackinnon M, et al.  Omeprazole v ranitidine for prevention of relapse in reflux oesophagitis: a controlled double blind trial of their efficacy and safety . Gut . 1994;;35:590-598.
19 +
Vigneri S, Termini R, Leandro G, et al.  A comparison of five maintenance therapies for reflux esophagitis . N Engl J Med . 1995;;333:1106-1110.
20 +
Robinson M, Lanza F, Avner D, Haber M.  Effective maintenance treatment of reflux esophagitis with low-dose lansoprazole: a randomized double blind placebo-controlled trial . Ann Intern Med . 1996;; 124:859-867.
21 +
Freston JW.  Omeprazole, hypergastrinemia, and gastric carcinoid tumors . Ann Intern Med . 1994;;121:232-234.
22 +
Kuipers EJ, Lundell L, Klinkenberg-Knol EC, et al.  Atrophic gastritis and Helicobacter pylori infection in patients with reflux esophagitis treated with omeprazole or fundoplication . N Engl J Med . 1996;;334:1018-1022.
23 +
Peters JH, DeMeester TR. Minimally Invasive Surgery of the Foregut . St Louis, Mo: Quality Medical Publishing; 1994;.
24 +
Hinder RA, Filipi CJ, Wetscher G, DeMeester TR, Perdikis G.  Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease . Ann Surg . 1994;;220:472-481.
25 +
Trus TL, Laycock WS, Branum G, Waring JP, Mauren S, Hunter JG.  Intermediate follow-up of laparoscopic antireflux surgery . Am J Surg . 1996;;171:32-35.
26 +
Spechler SJ, Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group.  Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans . N Engl J Med . 1992;;326:786-792.
27 +
Cameron AJ, Higgins JA.  Linear gastric erosion, a lesion associated with large diaphragmatic hernia and chronic blood loss anemia . Gastroenterology . 1986;;91:338-342.
28 +
Wesdorp IC, Bartelsman JF, den Hartog Jager FC, Huibregtse K, Tytgat GN.  Results of conservative treatment of benign esophageal stricture: a follow-up study in 100 patients . Gastroenterology . 1982;;82:487-493.
29 +
Patterson DJ, Graham DY, Smith JL, et al.  Natural history of benign esophageal stricture treated by dilatation . Gastroenterology . 1983;;85:346-350.
30 +
Mercer CD, Hill LD.  Surgical management of peptic esophageal stricture: twenty-year experience . J Thorac Cardiovasc Surg . 1986;;91:371-378.
31 +
Marks RD, Richter JE, Rizzo J, et al.  Omeprazole versus H2-receptor antagonists in treating patients with peptic stricture and esophagitis . Gastroenterology . 1994;;106:907-915.
32 +
Morson BC, Sobin LH, Grundmann E, Johansen A, Nagayo T, Serck-Hanssen A.  Pre-cancerous conditions and epithelial dysplasia in the stomach . J Clin Pathol . 1980;;33:711-721.
33 +
Sampliner RE.  Effect of up to 3 years of highdose lansoprazole on Barrett's esophagus . Am J Gastroenterol . 1994;;89:1844-1848.
34 +
Spechler SJ, Goyal RK.  Barrett's esophagus . N Engl J Med . 1986;;315:362-371.
35 +
Cameron AJ, Ott BJ, Payne WS.  The incidence of adenocarcinoma in columnar-lined (Barrett's) esophagus . N Engl J Med . 1985;;313:857-859.
36 +
Spechler SJ, Zeroogian JM, Antonioli DA, Wang HH, Goyal RJ.  Prevalence of metaplasia at the gastrooesophageal junction . Lancet . 1994;;344:1533-1536.
37 +
Schnell TG, Sontag SJ, Chejfec G.  Adenocarcinomas arising in tongues or short segments of Barrett's esophagus . Dig Dis Sci . 1992;;37:137-143.
38 +
Blot WJ, Devesa SS, Kneller RW, Fraumeni JF.  Rising incidence of adenocarcinoma of the esophagus and gastric cardia . JAMA . 1991;;265:1287-1289.
39 +
Blot WJ, Devesa SS, Fraumeni JF.  Continuing climb in rates of esophageal adenocarcinoma: an update . JAMA . 1993;;270:1320.
40 +
Clark GWB, Smyrk TC, Burdiles P, et al.  Is Barrett's metaplasia the source of adenocarcinomas of the cardia? Arch Surg . 1994;;129:609-614.
41 +
Sampliner RE, Jaffe P.  Malignant degeneration of Barrett's esophagus; the role of laser ablation and photodynamic therapy . Dis Esophagus . 1995;;8:104-108.
42 +
Fennerty MB, Sampliner RE, Garewal HS.  Review article: Barrett's esophagus—cancer risk, biology and therapeutic management . Aliment Pharmacol Ther . 1993;;7:339-345.
43 +
Dent J, Bremner CG, Collen MJ, Haggitt RC, Spechler SJ. Barrett's Oesophagus: Working Party Reports of the Ninth World Congresses of Gastroenterology . Melbourne, Australia: Blackwell Scientific Publications; 1990;:17-26.
44 +
Ing AJ, Ngu MC, Breslin ABX.  The pathogenesis of chronic persistent cough associated with gastroesophageal reflux . Am J Respir Crit Care Med . 1994;;149:160-167.
45 +
Schroeder PL, Filler SJ, Ramierez B, Lazarchik DA, Vaezi MF, Richter JE.  Dental erosions and acid reflux disease . Ann Intern Med . 1995;;122:809-815.
46 +
Sontag SJ, O'Connell S, Khandelwal S, et al.  Most asthmatics have gastroesophageal reflux with or without bronchodilator therapy . Gastroenterology . 1990;;99:613-620.
47 +
Harding SM, Richter JE, Guzzo MR, Schan CA, Alexander RW, Bradley LA.  Asthma and gastroesophageal reflux: acid suppressive therapy improves asthma outcome . Am J Med . 1996;;100:395-405.
48 +
Mansfield LE, Stein MR.  Gastroesophageal reflux and asthma: a possible reflex mechanism . Ann Allergy . 1978;;41:224-226.
49 +
Tuchman DN, Boyle JT, Pack AI, et al.  Comparison of airway responses following tracheal or esophageal acidification in the cat . Gastroenterology . 1984;;87:872-881.
50 +
Crausaz FM, Favez G.  Aspiration of solid food particles into the lungs of patients with gastroesophageal reflux and chronic bronchial disease . Chest . 1988;;93:376-378.
51 +
Larrain A, Carrasco E, Galleguillos F, Sepulveda R, Pope CE.  Medical and surgical treatment of nonallergic asthma associated with gastroesophageal reflux . Chest . 1991;;99:1330-1335.
52 +
Jacob P, Kahrilas PJ, Herzon G.  Proximal esophageal pH-metry in patients with 'reflux laryngitis.' Gastroenterology . 1991;;100:305-310.
53 +
Koufman JA.  The otolaryngologic manifestations of gastroesophageal reflux disease . Laryngoscope . 1991;;10( (suppl 53) ):1-78.
54 +
Shaker R, Milbrath M, Ren J, et al.  Esophagopharyngeal distribution of refluxed gastric acid in patients with reflux laryngitis . Gastroenterology . 1995;;109:1575-1572.
55 +
Cote DN, Miller RH.  The association of gastroesophageal reflux and otolaryngologic disorders . Compr Ther . 1995;;21:80-84.
56 +
Gaynor EB.  Gastroesophageal reflux as an etiologic factor in laryngeal complications of intubation . Laryngoscope . 1988;;98:972-979.
57 +
Cherry J, Margulies SI.  Contact ulcer of the larynx . Laryngoscope . 1968;;78:1937-1940.
58 +
Kambic V, Radsel Z.  Acid posterior laryngitis, aetiology, histology, diagnosis and treatment . J Laryngol Otol . 1984;;98:1237-1240.
59 +
Kamel PL, Hanson D, Kahrilas PJ.  Prospective trial of omeprazole in the treatment of posterior laryngitis . Am J Med . 1994;;96:321-326.
60 +
Hanson DG, Kamel PL, Kahrilas PJ.  Outcomes of anti-reflux therapy in the treatment of chronic laryngitis . Ann Otol Rhinol Laryngol . 1995;;104:550-555.
61 +
Wydner EL, Stellman SD.  Comparative epidemiology of tobacco-related cancers . Cancer Res . 1977;;37:4608-4622.
62 +
Olsen NR.  Effects of stomach acid on the larynx . Proc Am Laryngol Assoc . 1983;;104:108-112.
63 +
Morrison MD.  Is chronic gastroesophageal reflux a causative factor in glottic carcinoma? Otolaryngol Head Neck Surg . 1988;;99:370-373.
64 +
Ward PH, Hanson DG.  Reflux as an etiologic factor of carcinoma of the laryngopharynx . Laryngoscope . 1988;;98:1195-1199.
65 +
Kahrilas PJ, Clouse RE, Hogan WJ.  American Gastroenterological Association technical review on the clinical use of esophageal manometry . Gastroenterology . 1994;;107:1865-1884.
66 +
Kahrilas PJ, Quigley EMM.  Clinical esophageal pH monitoring, a technical review for practice guideline development . Gastroenterology . 1996;;110:1982-1996.

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