TY - JOUR T1 - Different clinical symptom patterns in patients with reflux micro-micro-aspiration JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00508-2021 SP - 00508-2021 AU - Oleksandr Khoma AU - Jin-soo Park AU - Felix Michael Lee AU - Hans Van der Wall AU - Gregory L Falk Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/11/04/23120541.00508-2021.abstract N2 - Background Pulmonary manifestation of gastro-oesophageal reflux disease (GORD) is a well-recognised entity, however little primary reported data exists on presenting symptoms of patients in whom reflux micro-aspiration is confirmed. The aim of this study is to report symptoms and presenting patterns of a large group of patients with confirmed reflux micro-aspiration.Patients and methods Data was extracted from a prospectively populated database of patients referred to a tertiary specialist centre with severe, refractory, or atypical reflux. Patients with reflux micro-aspiration on scintigraphy were included in this study. Separate group included patients with evidence of proximal reflux to the level of pharynx when supine and/or upright.Results Inclusion criteria were met by 243 patients with confirmed reflux micro-aspiration (33% males; mean age 59). Most common symptoms amongst patients with micro-aspiration were regurgitation (72%), cough (67%), heartburn (66%), throat clearing (65%), and dysphonia (53%). The most common two-symptom combinations were heartburn/regurgitation, cough/throat clearing, regurgitation/throat clearing, cough/regurgitation and dysphonia/throat clearing. The most common three-symptom combinations were cough/heartburn/regurgitation, cough/regurgitation/throat clearing and dysphonia/regurgitation/throat clearing. Cluster analysis demonstrated two main symptom groupings, one suggestive of proximal volume reflux symptoms and the other with motility/inflammatory bowel syndrome (IBS)-like symptoms (bloat, constipation).Conclusion Combination of typical symptoms of GORD such as heartburn or regurgitation and a respiratory or upper aero-digestive complaint such as cough, throat clearing, or voice change should prompt consideration of reflux micro-aspiration.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Oleksandr Khoma has nothing to disclose.Conflict of interest: Jin-soo Park has nothing to disclose.Conflict of interest: Felix Michael Lee has nothing to disclose.Conflict of interest: Hans Van der Wall has nothing to disclose.Conflict of interest: Gregory L Falk has nothing to disclose. ER -