Ear, nose and throat and respiratory manifestations of gastro-esophageal reflux disease: an increasing conundrum.

Although recent studies suggest that gastro-oesophageal reflux disease (GORD) may contribute frequently to ear, nose and throat (ENT) and respiratory diseases, the cause-and-effect relationship is far from proven. This article addresses this controversial topic, emphasising recent literature that raises concerns about the credibility of this association and our tests to make this diagnosis. The author believes that these extra-oesophageal symptoms suspected to be secondary to GORD are a conundrum, but selective use of aggressive proton-pump-inhibitor therapeutic trials may help to resolve this issue in our patients.