TO THE EDITOR: In the August 2004 issue of this journal, Poelmans et al. reported the results of their study, which was designed to investigate the prevalence and severity of endoscopic esophagitis in patients with ENT problems and patients with typical gastroesophageal reflux disease (GERD) symptoms (1). The authors observed a higher prevalence of endoscopic esophagitis in patients presenting with ENT symptoms.

During the past years, ENT manifestations of GERD gained tremendous attention. In recent studies, gastroesophageal reflux, detected by either 24-hour pH monitoring or endoscopy, was demonstrated in 40–60% of the cases presenting with ENT problems (2–4). We have conducted a study in which the relationship between upper respiratory tract symptoms and the frequency of reflux esophagitis was investigated. Our study group consisted of 28 children with ENT symptoms such as chronic cough, sinusitis, and otitis and 55 patients with classical gastroesophageal symptoms such as easy vomiting and heartburn. The patients had no apparent cause explaining ENT symptoms and were unresponsive to the conventional medical therapies (ie., antibiotics, antihistamines, corticosteroids). When the results of two groups with regard to the symptoms and presence of histological esophagitis were compared, the prevalence of esophagitis was higher in the first group with ENT symptoms than in the second group with classical GERD symptoms (64.3% and 54.5%, respectively, p= 0.06). Laryngeal area was examined in all patients during endoscopy and the presence of hyperemia of arythenoids and edema of vocal cords was detected almost two times higher in patients presenting with ENT symptoms when compared to the patients with classical GERD symptoms.