High Prevalence of Proximal and Distal Gastroesophageal Reflux Disease in Advanced COPD

Kempainen, Robert R.; Savik, Kay; Whelan, Timothy; Dunitz, Jordan M.; Herrington, Cynthia; Billings, Joanne

doi:10.1378/chest.06-2264

Cited by 88 publications

(81 citation statements)

References 26 publications

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“…The severity of hyperinflation and dyspnea may be important associated risk factors for the incidence of GERD symptoms in patients with clinically stable COPD [14]. Terada et al, also concluded that GERD symptoms were identified as an important factor associated with COPD exacerbation [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Gastroesophageal Reflux Symptoms in Patients with Chronic Obstructive Pulmonary Disease

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Gastroesophageal Reflux Symptoms in Patients with Chronic Obstructive Pulmonary Disease

et al. 2014

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“…The esophagus is affected in 50-82% of patients with SSc (11). Gastric reflux may be liquid, gaseous, or particulate; acid or nonacid; distal (localized to the distal oesophagus) or proximal (reaching the proximal oesophagus and pharynx) (12). Reflux to the proximal oesophagus, which is intuitively linked to microaspiration into the lungs, appears to be quite common in patients with ILD-SSc and IPF © C I C E d i z i o n i I n t e r n a z i o n a l i (13,14).…”

Section: Introductionmentioning

confidence: 99%

The role of gastro-esophageal reflux (GER) in systemic sclerosis and lung fibrosis

Lauretis¹

2014

SOB

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SummarySystemic sclerosis (SSc) is an autoimmune condition characterized by tissue fibrosis of the skin and internal organs. A significant subgroup of SSc patients develops progressive interstitial lung disease (ILD) leading to pulmonary fibrosis similar to IPF (idiopathic pulmonary fibrosis). Gastro-esophageal reflux (GER) has been suggested as a driving factor in the pathogenesis of both SSc-ILD and IPF. The esophagus is affected in 50-82% of patients with SSc. Gastric reflux may be liquid, gaseous, or particulate; acid or nonacid; distal (localized to the distal oesophagus) or proximal (reaching the proximal oesophagus and pharynx). Reflux to the proximal oesophagus, which is intuitively linked to microaspiration into the lungs, appears to be quite common in patients with ILD-SSc and IPF. Importantly, a significant proportion of GER reflux is asymptomatic. Concentration of pepsin and bile acids in bronchoalveolar lavage (BAL) and exhaled breath condensate (EBC) have been investigated as biomarkers of microaspiration in various respiratory diseases. The confirmation of a causative link of microaspiration in the genesis and progression of lung fibrosis would have a major impact in the management of ILD-SSc patients. It is likely that proteases such as pepsin, and not the acidity, are the primary target for future therapies. Potent inhibitors specific for proteases, e.g. pepstatin, are available and have been tested in phase-III clinical trials.

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“…[3][4][5] Increased gastroesophageal reflux (GER), diagnosed with 24 hour esophageal pH monitoring, has been identified in COPD and bronchiectasis. [6][7][8][9] Various physiological mechanisms, including lower esophageal sphincter relaxations and a raised intraabdominal pressure, have the potential to increase GER events [10][11][12][13] and these may arise during specific exercise tasks or airway clearance therapies (including cough) 14 prescribed by a physiotherapist. To determine whether modifications to these techniques are necessary to minimize GER in COPD and bronchiectasis, it is important to explore their effect on gastroesophageal acid exposure.…”

Section: Introductionmentioning

confidence: 99%

Upright Positive Expiratory Pressure Therapy and Exercise: Effects on Gastroesophageal Reflux in COPD and Bronchiectasis

Lee¹,

Denehy²,

Wilson

et al. 2012

Respir Care

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. RESULTS: Fifty-seven participants (30 with bronchiectasis, 27 with COPD, mean ؎ SD age 61 ؎ 13 y, FEV 1 61.2 ؎ 24.6% predicted) completed the study. Episodes of isolated distal esophageal reflux occurred in 30% of participants during PEP therapy, 22% during the 6MWT, and 20% during the GST. However, there was no significant difference in distal RI during 6MWT or PEP therapy, compared to BGT (all P > .05). The number of reflux episodes was decreased, compared to BGT during the GST (P ‫؍‬ .001) and 6MWT (P ‫؍‬ .001), but not during PEP therapy (P ‫؍‬ .71). CONCLUSIONS: Episodes of gastroesophageal reflux may occur during physiotherapy tasks, including airway clearance therapy using mouthpiece PEP, the 6MWT, and a measure of upper limb movement. However, as these activities did not increase the frequency of these events, no modifications to these tasks to minimize the occurrence of gastroesophageal reflux are necessary.

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High Prevalence of Proximal and Distal Gastroesophageal Reflux Disease in Advanced COPD

Cited by 88 publications

References 26 publications

Gastroesophageal Reflux Symptoms in Patients with Chronic Obstructive Pulmonary Disease

Gastroesophageal Reflux Symptoms in Patients with Chronic Obstructive Pulmonary Disease

The role of gastro-esophageal reflux (GER) in systemic sclerosis and lung fibrosis

Upright Positive Expiratory Pressure Therapy and Exercise: Effects on Gastroesophageal Reflux in COPD and Bronchiectasis

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