Surgical treatment of respiratory complications associated with gastroesophageal reflux disease.

Although the association between gastroesophageal reflux (GER) and typical esophageal symptoms, such as heartburn and regurgitation, is straightforward, this is not the case for the relation between GER and respiratory symptoms. The strongest link is the finding of abnormal reflux in the proximal esophagus or pharynx. This finding, in conjunction with evidence of airway injury such as seen on laryngoscopy, strongly supports the relation between GER and airway disease. Medical therapy provides relief to some patients, but with less consistency than for those with typical symptoms of GER disease. This is likely due to persistent aspiration or injury from supraesophageal reflux. Laparoscopic antireflux surgery is extremely safe and effective for reducing reflux as well as aspiration, and appears to be more effective than medical treatment for treating GER-related respiratory symptoms.