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GERD may lead to pulmonary complications through the \u201creflux\u201d (aspiration) or \u201creflex\u201d (refluxate\u2010triggered, vagally mediated airway spasm) mechanisms. While GERD may cause or worsen pulmonary disorders, changes in respiratory mechanics due to lung disease may also increase reflux. Typical esophageal symptoms are frequently absent and objective assessment with reflux monitoring is often needed for diagnosis. Impedance monitoring should be considered in addition to traditional pH study due to the involvement of both acidic and weakly acidic\/nonacidic reflux. Antireflux therapy may improve outcomes of some pulmonary complications of GERD, although careful selection of a candidate is paramount to successful outcomes. Further research is needed to identify the optimal testing strategy and patient phenotypes that would benefit from antireflux therapy to improve pulmonary outcomes.<\/jats:p>","DOI":"10.1111\/nyas.14460","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:48:32Z","timestamp":1597711712000},"page":"95-105","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Extraesophageal syndrome of gastroesophageal reflux: relationships with lung disease and transplantation outcome"],"prefix":"10.1111","volume":"1482","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1709-8230","authenticated-orcid":false,"given":"Walter W.","family":"Chan","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Ahuja","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Pennsylvania  Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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