Inhaled Beta Agonist Bronchodilator Does Not Affect Trans-diaphragmatic Pressure Gradient but Decreases Lower Esophageal Sphincter Retention Pressure in Patients with Chronic Obstructive Pulmonary Disease (COPD) and Gastroesophageal Reflux Disease (GERD)

Grande, L; Herbella, Fernando A. M.; Bigatão, Amilcar Marcelo; Jardim, José R.; Patti, Marco G.

doi:10.1007/s11605-016-3192-1

Cited by 11 publications

(7 citation statements)

References 21 publications

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“…27 In addition, some medications to treat COPD weaken the gastroesophageal barrier by decreasing the pressure of the sphincter. 28 There are currently no series focused on the outcomes of antireflux operations on COPD.…”

Section: No 1 Copd and Gerdmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease Exacerbations Are Influenced by Gastroesophageal Reflux Disease

Bigatão

Herbella

Grande

et al. 2018

The American Surgeon

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Gastroesophageal reflux disease (GERD) is associated with different pulmonary diseases, including chronic obstructive pulmonary disease (COPD). Whether GERD is contributory to COPD severity remains unclear. This study aims to evaluate the contribution of GERD to the clinical manifestation of COPD based on ventilatory parameters and yearly clinical exacerbations. We studied 48 patients (56% females, age 66 years) with COPD. All patients underwent high-resolution manometry and esophageal pH monitoring. The patients were separated into two groups according to the presence of GERD. GERD was present in 21 (44%) patients. GERD + and GERD – groups did not differ in regard to gender, age, and body mass index. Pulmonary parameters were not different in the absence or presence of GERD. The number of yearly exacerbations was higher in patients GERD1. The severity of GERD (as measured by DeMeester score) correlated with the number of exacerbations. Our results show the following: 1) GERD does not influence pulmonary parameters and 2) GERD is associated with a higher number of annual clinical exacerbations. We believe GERD must be objectively tested in patients with COPD because the prevalence of GERD in these patients is underestimated when only symptoms are considered. GERD treatment might decrease the frequency of episodes of exacerbation.

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Section: No 1 Copd and Gerdmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease Exacerbations Are Influenced by Gastroesophageal Reflux Disease

Bigatão

Herbella

Grande

et al. 2018

The American Surgeon

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“…Medicines such as beta-agonist bronchodilators lower the tone of LES in patients with COPD, decreasing the function of the anti-reflux barrier. 4 , 13 Other medicines, such as theophylline and inhaled steroids, increase the reflux, but we still do not know the exact mechanisms that regulate these processes. 4 …”

Section: Introductionmentioning

confidence: 99%

Low back pain and gastroesophageal reflux in patients with COPD: the disease in the breath

Bordoni

Marelli²,

Bruno³

et al. 2018

COPD

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COPD is a worsening condition that leads to a pathologic degeneration of the respiratory system. It represents one of the most important causes of mortality and morbidity in the world, and it is characterized by the presence of associated comorbidity. This article analyzes gastroesophageal reflux disease (GERD) and low back pain (LBP) in patients with COPD and tries to produce anatomo-clinical considerations on the reasons of the presence of these comorbidities. The considerations of the authors are based on the anatomic functions and characteristics of the respiratory diaphragm that are not always considered, from which elements useful to comprehend the symptomatic status of the patient can be deduced, finally improving the therapeutic approach. The information contained in the article can be of help to the clinician and for physiotherapy, and to all health professionals who gravitate around the patient’s care, improving the approach to the diaphragm muscle.

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“…However, in clinical practice, a beta‐agonist is often used for this purpose. Since a beta‐agonist is known to decrease lower esophageal sphincter pressure, 19 and since a decrease of the lower esophageal sphincter pressure is a risk factor to increase GER, 1 our findings should be confirmed using a beta‐agonist to humidify the airways.…”

Section: Discussionmentioning

confidence: 59%

The influence of Intrapulmonary percussive ventilation on gastroesophageal reflux in infants under the age of 1 year

Lievens

Vandenplas

Vanlaethem

et al. 2020

Pediatric Pulmonology

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Background: Intrapulmonary percussive ventilation (IPV) is an airway clearance technique used at any age to facilitate the removal of secretions from the respiratory tract. The effect of IPV on gastroesophageal reflux(GER) is not well documented. This study aimed to determine the influence of IPV on GER in infants. Methods: During a 24-hour multichannel intraluminal impedance-pH monitoring (MII-pH), infants in the intervention group received a20 minutes session of IPV in upright position, 2 hours postprandial. The control group received no intervention and was placed in the same position for 20 minutes, 2 hours postprandial. The number of reflux episodes (REs) during IPV as compared to the number of REs in the control group during the 20 minutes period. Results: Fifty infants were included in each group;21 infants in the IPV group and 14 infants in the control group were diagnosed with abnormal MII-pH (P = .142). During IPV, the number of REs was significantly lower than in the control group (P < .001). Also in the subgroups with abnormal or normal MII-pH, a significantly lower number of REs during IPV was found (P = .011, P = .011 respectively). Conclusion: IPV decreases the number of REs in infants independent of the results of MII-pH.

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Inhaled Beta Agonist Bronchodilator Does Not Affect Trans-diaphragmatic Pressure Gradient but Decreases Lower Esophageal Sphincter Retention Pressure in Patients with Chronic Obstructive Pulmonary Disease (COPD) and Gastroesophageal Reflux Disease (GERD)

Abstract: In conclusion, inhaled beta agonist bronchodilators not only increase the thoracic pressure but also lead to an increased abdominal pressure favoring GERD by affecting the esophagogastric barrier.

Cited by 11 publications

References 21 publications

Chronic Obstructive Pulmonary Disease Exacerbations Are Influenced by Gastroesophageal Reflux Disease

Chronic Obstructive Pulmonary Disease Exacerbations Are Influenced by Gastroesophageal Reflux Disease

Low back pain and gastroesophageal reflux in patients with COPD: the disease in the breath

The influence of Intrapulmonary percussive ventilation on gastroesophageal reflux in infants under the age of 1 year

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