Intrathoracic airway obstruction and gastroesophageal reflux: A canine model

Bhatia, Ruchi; Pagala, Murali; Vaynblat, Mikhail; Marcus, Michael; Kazachkov, Mikhail

doi:10.1002/ppul.22510

Cited by 4 publications

(4 citation statements)

References 28 publications

(55 reference statements)

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“…The results in this complex model failed to demonstrate the presence of GER as shown by the pH recordings and reflux index after the creation of the thoracoabdominal pressure gradient. The major limitations were the number of animals and the method for producing of tracheal obstruction ( 37 ).…”

Section: Pathophysiology Of Tracheal Stenosis In Patients With Germentioning

confidence: 99%

Impact of gastroesophageal reflux in the pathogenesis of tracheal stenosis

Cardoso¹,

Minamoto²,

Bibas³

et al. 2020

Transl Cancer Res TCR

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Benign airway stenosis is a multifactorial and heterogeneous disease often occurring after tracheal intubation. Despite the frequent finding of pathological gastroesophageal reflux (GER) in benign tracheal stenosis, the cause-and-effect relationship between these two entities and its impact on the outcome of the stenosis itself have not been established. The altered ventilatory dynamics caused by an increased thoracoabdominal pressure gradient in such patients has been proposed as a central cause. The presence of GER in a setting of microaspiration can also induce changes in the local collagen proliferation response, as well as in the local microbiome of the tracheal stenosis site, which may potentially cause and enhance the harm imposed to the already diseased tracheal wall. Diagnosis of GER remains underestimated in the general population, thus making its accurate detection and treatment in central airway stenosis a matter of investigation. The high prevalence of GER in tracheal stenosis patients often occurs in the absence of typical upper digestive signs and symptoms, therefore requiring an objective assessment using a 24-hour ambulatory esophageal pH/impedance study that has shown abnormal results in more than half the patients. The impact of the treatment of GER in patients with benign tracheal has been scarcely reported. Our group showed recently that the surgical control of GER through laparoscopic fundoplication in selected patients with tracheal stenosis can improve substantially the chance of resolution of the tracheal stenosis as opposed to the medical management with high dose proton pump inhibitors. This chapter describes the impact of GER in the pathogenesis of tracheal stenosis with a focus on its mechanisms, diagnosis and treatment strategy.

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Section: Pathophysiology Of Tracheal Stenosis In Patients With Germentioning

confidence: 99%

Impact of gastroesophageal reflux in the pathogenesis of tracheal stenosis

Cardoso¹,

Minamoto²,

Bibas³

et al. 2020

Transl Cancer Res TCR

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“…Patients with EA may represent a special case of lung impairment and the role of esophageal function in respiratory disease in patients with EA is not fully understood . The presence of EA disrupts the normal myenteric plexus in the esophagus, leading to impaired peristalsis, and congenital tracheal abnormalities in EA may negatively affect airway function in general.…”

Section: Introductionmentioning

confidence: 99%

Long-term pulmonary function in esophageal atresia-A case-control study

et al. 2016

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“…Although Barrett's esophagus is infrequent in dogs, spontaneous canine models of GER in brachycephalics with hiatal herniation do occur. Many of these dogs also have BOAS making them optimal models of aerodigestive disease to study the effects of sleep apnea syndrome (363), evaluate the relationships of intrathoracic pressure alterations and reflux (364), and interrogate the response to corrective airway surgery (168,365,366). The role of acid and airway reflux in aspiration pneumonia (367), laryngeal dysfunction or spasm (368,369), chronic cough and bronchoconstrictive airway disease (370) could also be studied in dogs and related back to in humans (371).…”

Section: Models For Translational Research and Medicinementioning

confidence: 99%

A Comparative Assessment of the Diagnosis of Swallowing Impairment and Gastroesophageal Reflux in Canines and Humans

et al. 2022

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Swallowing impairment is a highly prevalent and clinically significant problem affecting people and dogs. There are myriad causes of swallowing impairment of which gastroesophageal reflux is the most common in both species. Similarities in anatomy and physiology between humans and canines results in analogous swallowing disorders including cricopharyngeus muscle achalasia, esophageal achalasia, hiatal herniation, and gastroesophageal reflux with secondary esophagitis and esophageal dysmotility. Accordingly, the diagnostic approach to human and canine patients with swallowing impairment is similar. Diagnostic procedures such as swallowing fluoroscopy, high-resolution manometry, pH/impedance monitoring, and endolumenal functional luminal imaging probe can be performed in both species; however, nasofacial conformation, increased esophageal length, and the difficulty of completing several of these procedures in awake dogs are inherent challenges that need to be considered. Human patients can convey their symptoms and respond to verbal cues, whereas veterinarians must rely on clinical histories narrated by pet owners followed by comprehensive physical examination and observation of the animal eating different food consistencies and drinking water. Dogs may also be unwilling to drink or eat in the hospital setting and may be resistant to physical restraint during diagnostic procedures. Despite the species differences and diagnostic challenges, dogs are a natural animal model for many oropharyngeal and esophageal disorders affecting people, which presents a tremendous opportunity for shared learnings. This manuscript reviews the comparative aspects of esophageal anatomy and physiology between humans and canines, summarizes the diagnostic assessment of swallowing impairment in both species, and discusses future considerations for collaborative medicine and translational research.

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Intrathoracic airway obstruction and gastroesophageal reflux: A canine model

Abstract: We conclude that moderate IAO does not cause GER in our animal model. It can be explained by the absence of significant change in Pdi after creation of IAO.

Cited by 4 publications

References 28 publications

Impact of gastroesophageal reflux in the pathogenesis of tracheal stenosis

Impact of gastroesophageal reflux in the pathogenesis of tracheal stenosis

Long-term pulmonary function in esophageal atresia-A case-control study

A Comparative Assessment of the Diagnosis of Swallowing Impairment and Gastroesophageal Reflux in Canines and Humans

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