Gastroesophageal Reflux Disease and Connective Tissue Disorders: Pathophysiology and Implications for Treatment

Patti, Marco G.; Gasper, Warren J.; Fisichella, P. Marco; Nipomnick, Ian; Palazzo, Francesco

doi:10.1007/s11605-008-0674-9

Cited by 43 publications

(23 citation statements)

References 27 publications

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“…26,27 Interestingly, data from Europe and Australia show similar results for both procedures in terms of reflux control and the incidence of postoperative dysphagia. 28 As far as the long-term results of partial and total fundoplications, data suggest that both a Nissen and an anterior fundoplication are durable and provide good long-term results and that at 10 years, they both have the same control of reflux and dysphagia rates.…”

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confidence: 85%

Analysis of the Causes of Failed Antireflux Surgery and the Principles of Treatment

2015

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Laparoscopic antireflux surgery is a very effective and long-lasting treatment for gastroesophageal reflux disease. Its success is based on a careful preoperative evaluation and on the performance of a fundoplication that respects the key technical elements. Patients who are still symptomatic postoperatively must be thoroughly evaluated to identify the cause of failure, and treatment must be individualized.

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confidence: 85%

Analysis of the Causes of Failed Antireflux Surgery and the Principles of Treatment

2015

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“…The prevalence of ILD in patients with esophageal dilation was 92%, compared with 45% in patients without esophageal dilation. Patti et al (20) compared the esophageal motility pattern in patients with connective tissue disorders with or without pulmonary involvement. Forty-six percent of the patients with CTD and pulmonary involvement had no peristalsis.…”

Section: Does Impairment In the Esophageal Motility Have Influence Onmentioning

confidence: 99%

Interstitial lung disease and gastroesophageal reflux disease: key role of esophageal function tests in the diagnosis and treatment

Soares

Forsythe

Hogarth

et al. 2011

Arq. Gastroenterol.

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-Context -Gastroesophageal reflux disease (GERD) is common in patients with respiratory disorders and interstitial lung fibrosis from diverse disease processes. However, a cause-effect relationship has not been well demonstrated. It is hypothesized that there might be more than a coincidental association between GERD and interstitial lung damage. There is still confusion about the diagnostic steps necessary to confirm the presence of GERD, and about the role of effective control of GERD in the natural history of these respiratory disorders. Objectives -To determine the prevalence of GERD in patients with respiratory disorders and lung involvement; the sensitivity of symptoms in the diagnosis of GERD; and the role of esophageal function tests (manometry and 24-hour pH monitoring) in the diagnosis and treatment of these patients. Methods -Prospective study based on a database of 44 patients (29 females) with respiratory disorders: 16 patients had idiopathic pulmonary fibrosis, 11 patients had systemic sclerosis associated interstitial lung disease, 2 patients had polymyositis associated interstitial lung disease, 2 patients had Sjögren associated interstitial lung disease, 2 patients had rheumatoid artrithis associated interstitial lung disease, 1 patient had undifferentiated connective tissue diseases associated interstitial lung disease and 10 patients had sarcoidosis. The average forced vital capacity (% predicted) was 64.3%. All patients had esophageal function tests. Results -Thirty patients (68%) had pathologic reflux (average DeMeester score: 45, normal <14.7). The average number of reflux episodes recorded 20 cm above the lower esophageal sphincter was 24. Sensitivity and specificity of heartburn were 70% and 57%, of regurgitation 43% and 57%, and of dysphagia 33% and 64%. Twelve patients with GERD underwent a laparoscopic fundoplication which was tailored to the manometric profile: three patients in which peristalsis was normal had a total fundoplication (360°) and nine patients in which the peristalsis was absent had a partial anterior fundoplication (180°). Conclusions -The results of our study show that: (a) abnormal reflux was present in about 2/3 of patients with respiratory disorders (idiophatic pulmonary fibrosis, connective tissue disorders and sarcoidosis), and it extended to the upper esophagus in most patients; (b) the sensitivity and specificity of reflux symptoms was very low; and (c) esophageal function tests were essential to establish the diagnosis of abnormal reflux, to characterize the esophageal function and guide therapy. Long term follow-up will be necessary to determine if control of reflux alters the natural history of these respiratory disorders.

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“…Oesophageal dysmotility and gastroesophageal reflux disease, which are common in SSc patients (28), might increase the risk for infection and graft dysfunction (13,(29)(30)(31)(32)(33). Therefore, CTD-ILD is divided into subtypes, and comparative studies with other diseases have been conducted.…”

Section: Discussionmentioning

confidence: 99%

Comparison of short-term outcomes for connective tissue disease-related interstitial lung disease and idiopathic pulmonary fibrosis after lung transplantation

Park¹,

Kim²,

Song³

et al. 2018

J. Thorac. Dis.

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Background: Pulmonary involvement is common in connective tissue disease (CTD), and respiratory failure is a major cause of morbidity and mortality in CTD-related interstitial lung disease (CTD-ILD).Lung transplantation is thus important for these patients. However, survival, outcomes, and management of these patients after transplantation have been debated. The aim of this study was to evaluate the outcomes for CTD-ILD compared to those for idiopathic pulmonary fibrosis (IPF) after lung transplantation.Methods: We performed a single-centre retrospective study of 62 patients with CTD-ILD or IPF who underwent lung transplantation at a tertiary hospital in South Korea between October 2012 and October 2016. Results: Patients with CTD-ILD (n=15) were younger (46 vs. 60 years, P=0.001) and were less likely to be male (33.3% vs. 76.6%, P=0.004) than were patients with IPF (n=47). The 1-year cumulative survival rate was 80.0% for CTD-ILD and 59.6% for IPF (log-rank P=0.394). There was no difference in the cumulative survival rate (log-rank P=0.613) of age-and sex-matched patients with CTD-ILD (n=15) and IPF (n=15).The incidence of primary graft dysfunction was similar (P=0.154), and 2 (18.2%) patients developed possible CTD flare. Conclusions:Patients with CTD-ILD and those with IPF who underwent lung transplantation had similar survival rates.

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Gastroesophageal Reflux Disease and Connective Tissue Disorders: Pathophysiology and Implications for Treatment

Cited by 43 publications

References 27 publications

Analysis of the Causes of Failed Antireflux Surgery and the Principles of Treatment

Analysis of the Causes of Failed Antireflux Surgery and the Principles of Treatment

Interstitial lung disease and gastroesophageal reflux disease: key role of esophageal function tests in the diagnosis and treatment

Comparison of short-term outcomes for connective tissue disease-related interstitial lung disease and idiopathic pulmonary fibrosis after lung transplantation

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