Idiopathic pulmonary fibrosis and gastroesophageal reflux. Implications for treatment.
J Gastrointest Surg
; 18(1): 100-4; discussion 104-5, 2014 Jan.
Article
em En
| MEDLINE
| ID: mdl-24002768
ABSTRACT
BACKGROUND:
Even though the pathogenesis of idiopathic pulmonary fibrosis (IPF) is unknown, there is mounting evidence that abnormal reflux (GERD) and aspiration of gastric contents may play a role in the pathogenesis of this disease.AIMS:
The aims of this study were to determine in patients with GERD and IPF (a) the clinical presentation, (b) the esophageal function, and (c) the reflux profile.METHODS:
We compared the clinical presentation, the esophageal function (as defined by high-resolution manometry), and the reflux profile (by dual sensor pH monitoring) in 80 patients with GERD (group A) and in 22 patients with GERD and IPF (group B).RESULTS:
Heartburn was present in less than 60 % of patients with GERD and IPF. Lower esophageal sphincter pressure and peristalsis were normal in both groups, while the upper esophageal sphincter (UES) was more frequently hypotensive in IPF patients (p = 0.008). In patients with GERD and IPF, the proximal esophageal acid exposure was higher (p = 0.047) and the supine acid clearance was slower as compared with patients with GERD only (p < 0.001).CONCLUSIONS:
The results of this study show that in patients with GERD and IPF (a) reflux is frequently silent, (b) with the exception of a weaker UES, the esophageal function is preserved, and (c) proximal reflux is more common, and in the supine position, it is coupled with a slower acid clearance. Because these factors predisposing IPF patients to the risk of aspiration, antireflux surgery should be considered early after the diagnosis of IPF and GERD is established.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Refluxo Gastroesofágico
/
Esfíncter Esofágico Superior
/
Esfíncter Esofágico Inferior
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Fibrose Pulmonar Idiopática
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Gastrointest Surg
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Estados Unidos