Atypical GERD Symptoms on PPI Therapy Are More Likely in an Older Female Patient Group

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Purpose: Initiating PPI therapy on patients who present with symptoms of GERD has become the diagnostic and therapeutic standard of care. Many patients, however, present with ongoing symptoms, which range from the typical symptoms of heartburn, regurgitation, and chest pain to atypical symptoms such as cough, throat clearing, and hoarseness. Demographic characteristics of patients presenting with typical or atypical symptoms have not been identified. Aim: To determine if gender and age differences are present in patients on PPI therapy who present with typical versus atypical symptoms. Methods: A retrospective analysis of 200 consecutive patients who have undergone MII-pH from January 2005 to October 2006 was performed. All patients had residual symptoms despite twice daily PPI therapy, and were studied on treatment. Questionnaires asking patients to identify the most bothersome symptom were reviewed, as was the age and gender of each patient. Typical symptoms included heartburn, regurgitation, and chest pain. Atypical symptoms included cough, hoarseness, throat clearing, nausea, wheezing, globus, belching, indigestion, and shortness of breath. Results: The tables below summarize our review.Table 1: Gender analysisTable 2: Age analysisConclusion: Patients presenting with atypical GERD symptoms on PPI therapy are more likely to be female and older than those with persisting typical symptoms.