Extraesophageal syndrome of gastroesophageal reflux: relationships with lung disease and transplantation outcome

Walter W. Chan, Nitin Ahuja, P. Marco Fisichella, Sravanya Gavini, Vikram Rangan, Marcelo F. Vela

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)95-105
Number of pages11
JournalAnnals of the New York Academy of Sciences
Volume1482
Issue number1
DOIs
StatePublished - Dec 10 2020

Keywords

  • asthma
  • extraesophageal reflux
  • gastroesophageal reflux disease
  • idiopathic pulmonary fibrosis
  • lung transplant

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • History and Philosophy of Science

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