Extraesophageal syndrome of gastroesophageal reflux: relationships with lung disease and transplantation outcome. Issue 1 (17th August 2020)

• Record Type: Journal Article
• Authors: Chan, Walter W.; Ahuja, Nitin; Fisichella, P. Marco; Gavini, Sravanya; Rangan, Vikram; Vela, Marcelo F.
• Other Names: Giuli Robert guestEditor.
• Is Part Of: Annals of the New York Academy of Sciences. Volume 1482:Issue 1(2020)
• Page Start: 95
• Page End: 105
• Publication Date: 2020-08-17
• Subjects: gastroesophageal reflux disease -- extraesophageal reflux -- lung transplant -- asthma -- idiopathic pulmonary fibrosis; Medical sciences -- Periodicals; Medicine -- Periodicals; Science -- Periodicals; 610
• DOI: 10.1111/nyas.14460
• Languages: English
• ISSNs: 0077-8923

Abstract

Abstract: Gastroesophageal reflux disease (GERD) is prevalent and may be associated with both esophageal and extraesophageal syndromes, which include various pulmonary conditions. GERD may lead to pulmonary complications through the "reflux" (aspiration) or "reflex" (refluxate‐triggered, vagally mediated airway spasm) mechanisms. While GERD may cause or worsen pulmonary disorders, changes in respiratory mechanics due to lung disease may also increase reflux. Typical esophageal symptoms are frequently absent and objective assessment with reflux monitoring is often needed for diagnosis. Impedance monitoring should be considered in addition to traditional pH study due to the involvement of both acidic and weakly acidic/nonacidic reflux. Antireflux therapy may improve outcomes of some pulmonary complications of GERD, although careful selection of a candidate is paramount to successful outcomes. Further research is needed to identify the optimal testing strategy and patient phenotypes that would benefit from antireflux therapy to improve pulmonary outcomes. Abstract : Gastroesophageal reflux disease (GERD) may be associated with extraesophageal syndromes, including various pulmonary conditions. While GERD may cause or worsen pulmonary disorders, changes in respiratory mechanics due to lung disease may also increase reflux. This review will focus on discussing the association between GERD and lower airway pulmonary conditions, including lung transplant complications, and it describes how antireflux therapy may improve outcomes of some pulmonary complications of GERD.