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Ann Surg. Mar 1990; 211(3): 337–345.
PMCID: PMC1358440

Chronic respiratory symptoms and occult gastroesophageal reflux. A prospective clinical study and results of surgical therapy.

Abstract

Seventy-seven patients with a primary complaint of persistent cough, wheezing, and/or recurrent pneumonia were evaluated for the presence of occult gastroesophageal reflux disease. Fifty-four patients (70%) had increased esophageal acid exposure on 24-hour pH monitoring of the distal esophagus. In 28% of these patients the respiratory symptoms were thought to be due to aspiration because they occurred during or within 3 minutes after a reflux episode. In the other patients, the respiratory symptoms were either induced by or were unrelated to reflux episodes. The number of respiratory symptoms reported by the patients with increased esophageal acid exposure was directly related to the presence of a nonspecific esophageal motility abnormality (p less than 0.05). This suggested that a motility disorder contributes to aspiration by promoting the aboral flow of refluxed gastric juice. Seventeen patients with increased esophageal acid exposure had an antireflux operation to relieve their respiratory complaints. Patients whose respiratory symptoms induced reflux episodes were not helped by the procedure. Of the other patients, symptoms were abolished by the procedure only in those with normal esophageal motility. It is concluded that the majority of patients suffering from chronic unexplained respiratory symptoms have occult gastroesophageal reflux disease, but only a minority of them are helped by surgery. Carefully performed esophageal function studies are needed to select those patients who will benefit from a surgical antireflux procedure.

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Selected References

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  • BREAKEY AS, DOTTER CT, STEINBERG I. Pulmonary complications of cardiospasm. N Engl J Med. 1951 Sep 20;245(12):441–447. [PubMed]
  • Overholt RH, Voorhees RJ. Esophageal reflux as a trigger in asthma. Dis Chest. 1966 May;49(5):464–466. [PubMed]
  • Pearson JE, Wilson RS. Diffuse pulmonary fibrosis and hiatus hernia. Thorax. 1971 May;26(3):300–305. [PMC free article] [PubMed]
  • Sontag S, O'Connell S, Greenlee H, Schnell T, Chintam R, Nemchausky B, Chejfec G, Van Drunen M, Wanner J. Is gastroesophageal reflux a factor in some asthmatics? Am J Gastroenterol. 1987 Feb;82(2):119–126. [PubMed]
  • Winans CS, Harris LD. Quantitation of lower esophageal sphincter competence. Gastroenterology. 1967 May;52(5):773–778. [PubMed]
  • DeMeester TR, Wang CI, Wernly JA, Pellegrini CA, Little AG, Klementschitsch P, Bermudez G, Johnson LF, Skinner DB. Technique, indications, and clinical use of 24 hour esophageal pH monitoring. J Thorac Cardiovasc Surg. 1980 May;79(5):656–670. [PubMed]
  • Johnson LF, Demeester TR. Twenty-four-hour pH monitoring of the distal esophagus. A quantitative measure of gastroesophageal reflux. Am J Gastroenterol. 1974 Oct;62(4):325–332. [PubMed]
  • Wynne JW, Ramphal R, Hood CI. Tracheal mucosal damage after aspiration. A scanning electron Microscope study. Am Rev Respir Dis. 1981 Dec;124(6):728–732. [PubMed]
  • Mansfield LE, Stein MR. Gastroesophageal reflux and asthma: a possible reflex mechanism. Ann Allergy. 1978 Oct;41(4):224–226. [PubMed]
  • Ghaed N, Stein MR. Assessment of a technique for scintigraphic monitoring of pulmonary aspiration of gastric contents in asthmatics with gastroesophageal reflux. Ann Allergy. 1979 May;42(5):306–308. [PubMed]
  • Ekström T, Lindgren BR, Tibbling L. Effects of ranitidine treatment on patients with asthma and a history of gastro-oesophageal reflux: a double blind crossover study. Thorax. 1989 Jan;44(1):19–23. [PMC free article] [PubMed]
  • Harper PC, Bergner A, Kaye MD. Antireflux treatment for asthma. Improvement in patients with associated gastroesophageal reflux. Arch Intern Med. 1987 Jan;147(1):56–60. [PubMed]
  • DeMeester TR, Bonavina L, Albertucci M. Nissen fundoplication for gastroesophageal reflux disease. Evaluation of primary repair in 100 consecutive patients. Ann Surg. 1986 Jul;204(1):9–20. [PMC free article] [PubMed]

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