{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:36:33Z","timestamp":1789061793375,"version":"build-2803163510"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Gastro-oesophageal reflux disease (GERD) may present with esophageal and\/or extra-oesophageal, laryngo-pharyngeal (LPR) symptoms including cough, throat clearing and dysphonia. A definitive diagnosis can be challenging, and existing treatments are often ineffective in resolving them. Oesophageal symptoms thought to be caused by GERD can overlap with those from functional dyspepsia (FD) and previous studies have proposed intestinal dysbiosis such as small intestinal bacteria overgrowth (SIBO) and intestinal methogenic overgrowth (IMO) as potential causes. This study aims to establish the relationship between SIBO\/IMO and LPR symptoms, and if their treatment improves LPR symptoms. We performed a retrospective cohort study of patients with SIBO or IMO in a high-volume, tertiary referral center for anti-reflux procedures between 2018 and 2023. The primary outcome measures were GERD-HQRL and LPR\/RSI scores after treatment for SIBO\/IMO, and anti-reflux medication use. Twenty-three patients were eligible. The mean decrease in GERD-HQRL score was 11.8 (3.31) (P\u00a0=\u20090.0017). The mean decrease in RSI score was 8.57 (1.97) (P\u00a0=\u20090.0003). In patients with raised DeMeester scores, the GERD-HQRL scores improved by 17.2 (5.02) (P\u00a0=\u20090.009) and RSI scores by 9.33 (3.60) (P\u00a0=\u20090.03). The symptom association probability was highest at 72.7% (n\u2009=\u20098) for belching; followed by 80% for heartburn (n\u2009=\u20094) and 66.7% for regurgitation (n\u2009=\u20094). The use of PPIs decreased in 95% (n\u2009=\u200919) of patients; 18 had stopped PPIs completely. All patients avoided potential surgical interventions. The diagnosis and treatment of SIBO in patients with atypical reflux symptoms may prevent unnecessary surgical and pharmacological treatments. Further prospective work is required to confirm this.<\/jats:p>","DOI":"10.1093\/dote\/doaf001","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T20:06:24Z","timestamp":1743624384000},"source":"Crossref","is-referenced-by-count":1,"title":["Treatment of oesophageal and laryngo-pharyngeal symptoms of reflux in patients diagnosed with SIBO and IMO with antibiotics"],"prefix":"10.1093","volume":"38","author":[{"given":"Swathikan","family":"Chidambaram","sequence":"first","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Steven","sequence":"additional","affiliation":[{"name":"RefluxUK LTD , Priory Park Withyham East Sussex ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8650-2017","authenticated-orcid":false,"given":"Sheraz R","family":"Markar","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgery, University of Oxford , Oxford ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Boyle","sequence":"additional","affiliation":[{"name":"RefluxUK LTD, King Edward VII Hospital , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"issue":"8","key":"2025040218151921600_ref1","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1111\/j.1572-0241.2006.00630.x","article-title":"The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus","volume":"101","author":"Vakil","year":"2006","journal-title":"Am J Gastroenterol"},{"issue":"24","key":"2025040218151921600_ref2","doi-asserted-by":"crossref","first-page":"2536","DOI":"10.1001\/jama.2020.21360","article-title":"Gastroesophageal reflux disease a review","volume":"324","author":"Maret-Ouda","year":"2020","journal-title":"JAMA - J Am Med Assoc"},{"issue":"2","key":"2025040218151921600_ref3","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1053\/j.gastro.2017.07.045","article-title":"Presentation and epidemiology of gastroesophageal reflux disease","volume":"154","author":"Richter","year":"2018","journal-title":"Gastroenterology"},{"issue":"3","key":"2025040218151921600_ref4","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1136\/gutjnl-2016-313589","article-title":"Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis","volume":"67","author":"Eusebi","year":"2018","journal-title":"Gut"},{"issue":"11","key":"2025040218151921600_ref5","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1136\/gutjnl-2019-318260","article-title":"How to select patients for antireflux surgery? The ICARUS guidelines (international consensus regarding preoperative examinations and clinical characteristics assessment to select adult patients for antireflux surgery)","volume":"68","author":"Pauwels","year":"2019","journal-title":"Gut"},{"issue":"12","key":"2025040218151921600_ref6","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1001\/jama.294.12.1534","article-title":"Evaluation and management of laryngopharyngeal reflux","volume":"294","author":"Ford","year":"2005","journal-title":"JAMA"},{"issue":"16","key":"2025040218151921600_ref7","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1056\/NEJMcp0804684","article-title":"Clinical practice. 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