Assessment of Gastroesophageal Reflux Disease in Patients Exhibiting Otolaryngology Symptoms at a Tertiary Care Hospital

Background Gastroesophageal reflux disease (GERD) is characterized by repeated episodes of heartburn sensation or regurgitation; it can also present as extraesophageal symptoms, which include dysphagia and hoarseness alongside throat clearing. Patients frequently present with atypical GERD symptoms, which trigger admission to otolaryngology (ENT) practices; however, this often results in patients missing the opportunity for proper diagnosis and treatment by gastroenterologists. Objectives This study aims to analyze the frequency of ENT complaints among GERD patients referred to gastroenterology from ENT and to determine their response to proton pump inhibitor (PPI) therapy based on structured clinic follow-up regarding symptomatic improvement following initiation of the regimen. Methods This retrospective record review study was conducted at a tertiary hospital in Saudi Arabia, between January 1, 2018, and December 31, 2023. A total of 263 adult patients diagnosed with GERD and referred for ENT-related symptoms were included using consecutive sampling. Inclusion criteria were age ≥17 years, confirmed GERD based on either clinical or endoscopic findings via the Los Angeles classification (LA) grading system, and documented ENT complaints (e.g., sore throat, dysphagia, hoarseness, halitosis). Exclusion criteria were incomplete records, chronic pulmonary disease, or a history of neck/glottic surgery, radiotherapy, or malignancy. Data were collected from hospital records and analyzed using IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, New York, United States). The chi-square test was used to assess associations, with p<0.05 considered significant. Results The participants had a mean age of 50.7 years ± 20.2 years, with 168 female patients (63.9%) in the sample. The majority of patients (78.3%) exhibited GERD LA grade A, whereas dysphagia in 83 patients (31.6%) and sore throat in 74 patients (28.1%) were the most frequent ENT symptoms among patients. GERD LA grade C was significantly correlated with halitosis development (P<0.001). The treatment benefit reached 230 patients (87.5%), but halitosis development (p<0.001), snoring (p=0.01), and shortness of breath (p=0.036) were associated with unfavorable treatment responses. Conclusions Patients with ENT symptoms may have GERD even in the absence of typical reflux symptoms. Symptoms of halitosis and snoring indicate advanced or treatment-resistant GERD. Accurate diagnosis and effective management depend on tight collaboration between multiple medical disciplines.

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Journal
Cureus
Published
2025-12-13
DOI
https://doi.org/10.7759/cureus.99142
Primary Topic
Gastroesophageal reflux and treatments
Type
article
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article

Assessment of Gastroesophageal Reflux Disease in Patients Exhibiting Otolaryngology Symptoms at a Tertiary Care Hospital

Cureus
Gastroesophageal reflux and treatments
article

Assessment of Gastroesophageal Reflux Disease in Patients Exhibiting Otolaryngology Symptoms at a Tertiary Care Hospital

article en

Abstract

Background Gastroesophageal reflux disease (GERD) is characterized by repeated episodes of heartburn sensation or regurgitation; it can also present as extraesophageal symptoms, which include dysphagia and hoarseness alongside throat clearing. Patients frequently present with atypical GERD symptoms, which trigger admission to otolaryngology (ENT) practices; however, this often results in patients missing the opportunity for proper diagnosis and treatment by gastroenterologists. Objectives This study aims to analyze the frequency of ENT complaints among GERD patients referred to gastroenterology from ENT and to determine their response to proton pump inhibitor (PPI) therapy based on structured clinic follow-up regarding symptomatic improvement following initiation of the regimen. Methods This retrospective record review study was conducted at a tertiary hospital in Saudi Arabia, between January 1, 2018, and December 31, 2023. A total of 263 adult patients diagnosed with GERD and referred for ENT-related symptoms were included using consecutive sampling. Inclusion criteria were age ≥17 years, confirmed GERD based on either clinical or endoscopic findings via the Los Angeles classification (LA) grading system, and documented ENT complaints (e.g., sore throat, dysphagia, hoarseness, halitosis). Exclusion criteria were incomplete records, chronic pulmonary disease, or a history of neck/glottic surgery, radiotherapy, or malignancy. Data were collected from hospital records and analyzed using IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, New York, United States). The chi-square test was used to assess associations, with p<0.05 considered significant. Results The participants had a mean age of 50.7 years ± 20.2 years, with 168 female patients (63.9%) in the sample. The majority of patients (78.3%) exhibited GERD LA grade A, whereas dysphagia in 83 patients (31.6%) and sore throat in 74 patients (28.1%) were the most frequent ENT symptoms among patients. GERD LA grade C was significantly correlated with halitosis development (P<0.001). The treatment benefit reached 230 patients (87.5%), but halitosis development (p<0.001), snoring (p=0.01), and shortness of breath (p=0.036) were associated with unfavorable treatment responses. Conclusions Patients with ENT symptoms may have GERD even in the absence of typical reflux symptoms. Symptoms of halitosis and snoring indicate advanced or treatment-resistant GERD. Accurate diagnosis and effective management depend on tight collaboration between multiple medical disciplines.

CureusVol. 17(12)
King Abdulaziz University (SA), Umm al-Qura University (SA), University of Jeddah (SA), King Fahd Armed Forces Hospital (SA)
Openalex Percentile: Top 29%
Gastroesophageal reflux and treatments
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