scholarly journals S463 Range and Severity of Atypical and Typical Gastroesophageal Reflux Symptoms in Patients Undergoing Lung Transplant Evaluation

2021 ◽  
Vol 116 (1) ◽  
pp. S204-S205
Author(s):  
Roshni Bhat ◽  
Rishabh Khatri ◽  
Dariush Shahsavari ◽  
Zubair Malik ◽  
Henry P. Parkman
2019 ◽  
Vol 26 (19) ◽  
pp. 3497-3511 ◽  
Author(s):  
Teodora Surdea-Blaga ◽  
Dana E. Negrutiu ◽  
Mariana Palage ◽  
Dan L. Dumitrascu

Gastroesophageal reflux disease is a chronic condition with a high prevalence in western countries. Transient lower esophageal sphincter relaxation episodes and a decreased lower esophageal sphincter pressure are the main mechanisms involved. Currently used drugs are efficient on reflux symptoms, but only as long as they are administered, because they do not modify the reflux barrier. Certain nutrients or foods are generally considered to increase the frequency of gastroesophageal reflux symptoms, therefore physicians recommend changes in diet and some patients avoid bothering foods. This review summarizes current knowledge regarding food and gastroesophageal reflux. For example, fat intake increases the perception of reflux symptoms. Regular coffee and chocolate induce gastroesophageal reflux and increase the lower esophageal exposure to acid. Spicy foods might induce heartburn, but the exact mechanism is not known. Beer and wine induce gastroesophageal reflux, mainly in the first hour after intake. For other foods, like fried food or carbonated beverages data on gastroesophageal reflux is scarce. Similarly, there are few data about the type of diet and gastroesophageal reflux. Mediterranean diet and a very low carbohydrate diet protect against reflux. Regarding diet-related practices, consistent data showed that a “short-meal-to-sleep interval” favors reflux episodes, therefore some authors recommend that dinner should be at least four hours before bedtime. All these recommendations should consider patient’s weight, because several meta-analyses showed a positive association between increased body mass index and gastroesophageal reflux disease.


2021 ◽  
pp. 000313482199868
Author(s):  
Fernando A. M. Herbella ◽  
Marco G. Patti

Idiopathic pulmonary fibrosis (IPF) and gastroesophageal reflux disease (GERD) are undoubtedly related. Even though it is not clear yet which one is the primary disease, they certainly interact increasing each other’s severity. Symptoms are unreliable to diagnose GERD in patients with IPF, and objective evaluation with pH monitoring and/or bronchoalveolar lavage analysis is mandatory. Pharmacological treatment with proton pump inhibitors (PPIs) may bring control of IPF in few patients, but PPIs do not control reflux but just change the pH of the gastric refluxate. Surgical therapy based on a fundoplication is safe and effective as it controls any type of reflux, independently from the pH of the gastric refluxate. In patients waiting for lung transplantation (if they can tolerate a laparoscopic operation under general anesthesia), a fundoplication before the operation might block the progression of IPF, while after transplantation it might prevent rejection by preventing the bronchiolitis obliterans syndrome.


2000 ◽  
Vol 95 (9) ◽  
pp. 2422-2422
Author(s):  
Lyndon V. Hernandez ◽  
Nalini Guda ◽  
Aboud Affi ◽  
Jerrold Jacobson ◽  
Nimish B. Vakil

Medicina ◽  
2011 ◽  
Vol 47 (4) ◽  
pp. 28 ◽  
Author(s):  
Ahmed Fahim ◽  
Peter Dettmar ◽  
Alyn Morice ◽  
Simon Hart

Background and Objective. Idiopathic pulmonary fibrosis (IPF) is the most common of the idiopathic interstitial pneumonias. There is evidence of the increased prevalence of gastroesophageal reflux disease in patients with IPF. The aim of this prospective study was to evaluate reflux in patients with IPF by analyzing the scores of the reflux cough questionnaire, measurement of pepsin in exhaled breath condensate (EBC) to detect extraesophageal reflux, and Helicobacter pylori serology to evaluate the prevalence of this stomach bacterium in patients with IPF. Material and Methods. The Hull airway reflux questionnaire (HARQ) was completed by 40 patients with IPF and 50 controls in order to evaluate reflux symptoms. EBC was collected from 23 patients (17 patients with IPF and 6 controls) for measurement of pepsin by the lateral flow technique. A prospective study of 57 subjects (34 patients with IPF and 23 controls) for H. pylori antibody detection by ELISA was performed. Results. Significantly higher HARQ scores (maximum score, 70) were recorded in patients with IPF compared with controls (19.6 [SD, 12.4] vs. 3 [SD, 2.9], P<0.001). There was no significant difference in EBC pepsin positivity between patients with IPF and controls (2 of the 17 patients vs. none of the 6 controls, P=0.38). There was no significant difference in H. pylori serology between patients with IPF and controls (17 of the 34 patients vs. 14 of the 23 controls, P=0.42). Conclusion. Patients with IPF had significantly increased scores of airway reflux symptoms. However, no objective evidence of extraesophageal reflux or H. pylori infection in patients with IPF was obtained in this study. The role of gastroesophageal and extraesophageal reflux in pathogenesis of IPF should be evaluated in a larger prospective study.


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