Abstract
Gastro-oesophageal reflux (GOR) has been implicated in the aetiology of lung disease. Cystic fibrosis (CF) patients have a high incidence of GOR symptoms with demonstrable episodes of oesophageal acidification. We studied 24-hour ambulatory tracheal and oesophageal pH in 11 CF patients with GOR symptoms to identify any episodes of tracheal acidification and define their temporal relation to oesophageal reflux and respiratory symptoms. 8 patients had evidence of significant GOR (DeMeester score mean 58; range 17-107) and in 6 it was gross (DeMeester score > 30). 4 patients had tracheal acidification (defined as tracheal pH < 5.5): all had greatly raised DeMeester scores. Two patterns of lowered tracheal pH were seen: a gradual drift downwards of tracheal pH to < 5.5 which recovered slowly, and an acute fall in tracheal pH to < 5.5 with rapid recovery. Only one patient had a fall in peak expiratory flow in conjunction with a decline in tracheal pH, and no association was found between the presence of tracheal microaspiration and pulmonary function. We conclude that tracheal acidification occurs in adult CF patients with GOR.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allen C. J., Newhouse M. T. Gastroesophageal reflux and chronic respiratory disease. Am Rev Respir Dis. 1984 Apr;129(4):645–647. [PubMed] [Google Scholar]
- Barish C. F., Wu W. C., Castell D. O. Respiratory complications of gastroesophageal reflux. Arch Intern Med. 1985 Oct;145(10):1882–1888. [PubMed] [Google Scholar]
- Goodall R. J., Earis J. E., Cooper D. N., Bernstein A., Temple J. G. Relationship between asthma and gastro-oesophageal reflux. Thorax. 1981 Feb;36(2):116–121. doi: 10.1136/thx.36.2.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harper P. C., Bergner A., Kaye M. D. Antireflux treatment for asthma. Improvement in patients with associated gastroesophageal reflux. Arch Intern Med. 1987 Jan;147(1):56–60. doi: 10.1001/archinte.147.1.56. [DOI] [PubMed] [Google Scholar]
- Jack C. I., Walshaw M. J., Tran J., Hind C. R., Evans C. C. Twenty-four-hour tracheal pH monitoring--a simple and non-hazardous investigation. Respir Med. 1994 Jul;88(6):441–444. doi: 10.1016/s0954-6111(05)80047-2. [DOI] [PubMed] [Google Scholar]
- Ledson M. J., Tran J., Walshaw M. J. Prevalence and mechanisms of gastro-oesophageal reflux in adult cystic fibrosis patients. J R Soc Med. 1998 Jan;91(1):7–9. doi: 10.1177/014107689809100103. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nagel R. A., Brown P., Perks W. H., Wilson R. S., Kerr G. D. Ambulatory pH monitoring of gastro-oesophageal reflux in "morning dipper" asthmatics. BMJ. 1988 Nov 26;297(6660):1371–1373. doi: 10.1136/bmj.297.6660.1371. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nelson H. S. Gastroesophageal reflux and pulmonary disease. J Allergy Clin Immunol. 1984 May;73(5 Pt 1):547–556. doi: 10.1016/0091-6749(84)90509-8. [DOI] [PubMed] [Google Scholar]
- Orenstein S. R., Orenstein D. M. Gastroesophageal reflux and respiratory disease in children. J Pediatr. 1988 Jun;112(6):847–858. doi: 10.1016/s0022-3476(88)80204-x. [DOI] [PubMed] [Google Scholar]
- Scott R. B., O'Loughlin E. V., Gall D. G. Gastroesophageal reflux in patients with cystic fibrosis. J Pediatr. 1985 Feb;106(2):223–227. doi: 10.1016/s0022-3476(85)80291-2. [DOI] [PubMed] [Google Scholar]