Gastroesophageal reflux in Bronchiectasis and the effect of anti-reflux treatment

Abstract

BackgroundBronchiectasis is a progressive and fatal disease despite the available treatment regimens. Gastroesophageal reflux (GER) may play an important role in the progression of bronchiectasis. However, active anti-reflux intervention such as Stretta radiofrequency (SRF) and/or laparoscopic fundoplication (LF) have rarely been used to treat Bronchiectasis.Case PresentationSeven patients’ clinical outcomes for treating GER-related deteriorated bronchiectasis were retrospective reviewed. All patients were treated by SRF and/or LF, and had follow-up periods ranging from one to five years. Typical GER symptoms, respiratory symptoms, medication consumption and general health status were assessed during the follow-ups. At the latest follow-up all patients were alive. The typical GER symptoms disappeared in five people and were significantly improved in the other two. Two had complete remissions of both respiratory symptoms and bronchiectasis exacerbations; four had significantly improved respiratory symptoms to mild/moderate degrees as well as reduced or zero bronchiectasis exacerbations, which allowed them to resume the physical and social functions; one’s respiratory symptoms and bronchiectasis exacerbations were not much improved, yet she was in stable condition and satisfied with the results.ConclusionsPotentially, GER plays an important role in some patients with bronchiectasis, and active anti-reflux treatments can be beneficial. Future clinical studies are suggested to clarify GER’s role in bronchiectasis and to further determine whether anti-reflux interventions for GER can improve the outcomes of patients with bronchiectasis.

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

“…One consideration for those patients in whom aspiration is felt to be a driver or major contributor to the treatmentrefractoriness of their bronchiectasis, is correction of anatomical issues promoting reflux and aspiration, including fundoplication and laryngeal cleft repair (102)(103)(104). Aspiration may cause both direct tissue damage and bacterial inoculation of the airways, but could also modulate the growth and lifestyle patterns of pathogens in the airways, driving them to more virulent or chronic expression patterns (105).…”

Contribution of hiatal hernia to asthma in patients with gastroesophageal reflux disease

“…In addition, it has been reported that 58% of asthmatic patients have HH . Our previous studies have shown that HH is common in patients with reflux‐associated respiratory symptoms . However, it is unclear whether HH is associated with asthma in patients with GERD.…”

“…5 Our previous studies have shown that HH is common in patients with reflux-associated respiratory symptoms. [6][7][8][9] However, it is unclear whether HH is associated with asthma in patients with GERD. Therefore, the goal of this study was to investigate the relationship between HH and asthma in patients with GERD; and to evaluate the treatment effects of Nissen fundoplication (LNF) and LNF with concomitant hiatal hernia repair (LNF-HHR).…”

Gastroesophageal Reflux in Chronic Cough and Cough Syncope and the Effect of Antireflux Treatment

“…Fundoplication conducted under laparoscopy is becoming more minimally invasive and is safe with fewer complications such as dysphagia and bloating. 4,5,[26][27][28] Thus, surgery may have increasing value in the management of GER-related respiratory symptoms such as chronic cough and cough syncope. 25 These studies relating to the outcomes of surgical treatment lack controls and blinding, which suggests that a placebo effect also needs to be considered, and the high success rate experienced in the small case series may not be reproducible in controlled clinical trials.…”