Adnan Majid1, Fayez Kheir2, Daniel Alape2, Michael Kent2, Anthony Lembo3, Vikram V Rangan3, Megan Carreiro2, Sidhu P Gangadharan2. 1. Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address: amajid@bidmc.harvard.edu. 2. Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. 3. Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Abstract
BACKGROUND: Gastroesophageal reflux (GER) is increasingly recognized as an exacerbating or causal factor in several respiratory diseases. There is a high prevalence of GER in infants with airway malacia. However, such data are lacking in adults. METHODS: This retrospective study was conducted to determine the relationship between GER and excessive central airway collapse (ECAC). The study included consecutive patients with ECAC referred to the Complex Airway Center at Beth Israel Deaconess Medical Center who underwent esophageal pH testing for GER between July 2014 and June 2018. RESULTS: Sixty-three of 139 patients with ECAC (45.3%) had documented GER as shown by an abnormal esophageal pH test result. The mean DeMeester score was 32.2, with a symptom association probability of 39.7% of GER-positive patients. Twenty-nine of 63 patients (46%) with GER reported improvement in respiratory symptoms following maximal medical therapy or antireflux surgery without requiring further treatment for ECAC. CONCLUSIONS: GER is prevalent among patients with ECAC, and aggressive reflux treatment should be considered in these patients prior to considering invasive airway procedures or surgery.
BACKGROUND: Gastroesophageal reflux (GER) is increasingly recognized as an exacerbating or causal factor in several respiratory diseases. There is a high prevalence of GER in infants with airway malacia. However, such data are lacking in adults. METHODS: This retrospective study was conducted to determine the relationship between GER and excessive central airway collapse (ECAC). The study included consecutive patients with ECAC referred to the Complex Airway Center at Beth Israel Deaconess Medical Center who underwent esophageal pH testing for GER between July 2014 and June 2018. RESULTS: Sixty-three of 139 patients with ECAC (45.3%) had documented GER as shown by an abnormal esophageal pH test result. The mean DeMeester score was 32.2, with a symptom association probability of 39.7% of GER-positive patients. Twenty-nine of 63 patients (46%) with GER reported improvement in respiratory symptoms following maximal medical therapy or antireflux surgery without requiring further treatment for ECAC. CONCLUSIONS: GER is prevalent among patients with ECAC, and aggressive reflux treatment should be considered in these patients prior to considering invasive airway procedures or surgery.
Authors: S Ikeda; T Hanawa; T Konishi; M Adachi; S Sawai; W Chiba; S Kosaba; R Hatakenaka; Y Matsubara; T Funatsu Journal: Nihon Kyobu Shikkan Gakkai Zasshi Date: 1992-06
Authors: Sidhu P Gangadharan; Charles T Bakhos; Adnan Majid; Michael S Kent; Gaetane Michaud; Armin Ernst; Simon K Ashiku; Malcolm M DeCamp Journal: Ann Thorac Surg Date: 2011-03-05 Impact factor: 4.330
Authors: Michael D Crowell; Angela Bradley; Stephanie Hansel; Paula Dionisio; Hack Jae Kim; G Anton Decker; John K DiBaise; V K Sharma Journal: Am J Gastroenterol Date: 2009-02-17 Impact factor: 10.864
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