Idiopathic pulmonary fibrosis is associated with increased impedance measures of reflux compared to non‐fibrotic disease among pre‐lung transplant patients

Gavini, Sravanya; Finn, Raymond T.; Lo, Wai–Kit; Goldberg, Hilary J.; Burakoff, Robert; Feldman, Natan; Chan, Walter W.

doi:10.1111/nmo.12627

Cited by 37 publications

(30 citation statements)

References 25 publications

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“…Interestingly, less than 50% of IPF patients in these studies reported classic reflux symptoms such as heartburn and regurgitation . Idiopathic pulmonary fibrosis patients also have more bolus reflux when compared to patients with non‐fibrotic lung disease of similar clinical severity, suggesting that the high prevalence of GER in IPF is not solely a function of altered respiratory mechanics, but that GER may in fact contribute to pathogenesis of the underlying lung disease.…”

Section: Discussionmentioning

confidence: 95%

Lung disease severity in idiopathic pulmonary fibrosis is more strongly associated with impedance measures of bolus reflux than pH parameters of acid reflux alone

Gavini

Borges

Finn

et al. 2016

Neurogastroenterology Motil

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Section: Discussionmentioning

confidence: 95%

Lung disease severity in idiopathic pulmonary fibrosis is more strongly associated with impedance measures of bolus reflux than pH parameters of acid reflux alone

Gavini

Borges

Finn

et al. 2016

Neurogastroenterology Motil

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“…Today, there is evidence that aspiration of gastric and esophageal contents can cause a wide spectrum of respiratory disorders, from cough to lung fibrosis. 17,18 Among 110 patients with achalasia, Sinan et al reported the occurrence of at least one daily respiratory symptom in 51 of them (40%). 3 Regurgitation was present in 100% of our patients with respiratory symptoms, with choking in the supine position in 45%, suggesting that aspiration played a role in the pathogenesis of these symptoms.…”

Section: Achalasia and Respiratory Symptomsmentioning

confidence: 98%

Achalasia and Respiratory Symptoms: Effect of Laparoscopic Heller Myotomy

Andolfi

Kavitt

Herbella

et al. 2016

Journal of Laparoendoscopic & Advanced Surgical Techniques

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The results of this study showed that: (1) respiratory symptoms were present in 41% of patients; (2) patients with respiratory symptoms had a more dilated esophagus; and (3) surgical treatment resolved or improved respiratory symptoms in 92.5% of patients. This study underlines the importance of investigating the presence of respiratory symptoms along with the more common symptoms of achalasia and of early treatment before lung damage occurs.

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“…Additionally, in patients with idiopathic pulmonary fibrosis (IPF), GERD has been shown to have increased prevalence in comparison to other chronic lung diseases[46,50,51]. Gavini et al[52] demonstrated that patients with IPF undergoing pre-lung transplant evaluation have a significantly higher prevalence of abnormal reflux compared to those with COPD, after controlling for potential confounders such as underlying disease severity. Savarino et al[53] demonstrated that IPF patients had a higher total reflux episodes and total proximal reflux episodes compared to both non-IPF chronic lung disease patients and healthy volunteers.…”

Section: Gerd and Lung Disease: Significance Of The Problemmentioning

confidence: 99%

Role of gastroesophageal reflux disease in lung transplantation

Hathorn

Chan

2017

WJT

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Lung transplantation is one of the highest risk solid organ transplant modalities. Recent studies have demonstrated a relationship between gastroesophageal reflux disease (GERD) and lung transplant outcomes, including acute and chronic rejection. The aim of this review is to discuss the pathophysiology, evaluation, and management of GERD in lung transplantation, as informed by the most recent publications in the field. The pathophysiology of reflux-induced lung injury includes the effects of aspiration and local immunomodulation in the development of pulmonary decline and histologic rejection, as reflective of allograft injury. Modalities of reflux and esophageal assessment, including ambulatory pH testing, impedance, and esophageal manometry, are discussed, as well as timing of these evaluations relative to transplantation. Finally, antireflux treatments are reviewed, including medical acid suppression and surgical fundoplication, as well as the safety, efficacy, and timing of such treatments relative to transplantation. Our review of the data supports an association between GERD and allograft injury, encouraging a strategy of early diagnosis and aggressive reflux management in lung transplant recipients to improve transplant outcomes. Further studies are needed to explore additional objective measures of reflux and aspiration, better compare medical and surgical antireflux treatment options, extend follow-up times to capture longer-term clinical outcomes, and investigate newer interventions including minimally invasive surgery and advanced endoscopic techniques.

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Idiopathic pulmonary fibrosis is associated with increased impedance measures of reflux compared to non‐fibrotic disease among pre‐lung transplant patients

Cited by 37 publications

References 25 publications

Lung disease severity in idiopathic pulmonary fibrosis is more strongly associated with impedance measures of bolus reflux than pH parameters of acid reflux alone

Lung disease severity in idiopathic pulmonary fibrosis is more strongly associated with impedance measures of bolus reflux than pH parameters of acid reflux alone

Achalasia and Respiratory Symptoms: Effect of Laparoscopic Heller Myotomy

Role of gastroesophageal reflux disease in lung transplantation

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