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Gastro-oesophageal reflux and gastric aspiration in idiopathic pulmonary fibrosis patients.
MedLine Citation:
PMID:  23471347     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
To characterize gastro-oesophageal reflux (GOR) in idiopathic pulmonary fibrosis (IPF).Forty consecutive IPF patients underwent pulmonary high-resolution computed tomography (HRCT) scan and impedance-pH monitoring off anti-secretory therapy. The presence of pulmonary fibrosis was assessed using validated HRCT-scores. Reflux features included distal oesophageal acid exposure, number of acid/weakly-acidic reflux episodes and their proximal migration. Forty consecutive patients with interstitial lung disease other than IPF (non-IPF patients) and 50 healthy volunteers (HVs) were also enrolled.IPF patients had significantly higher (p<0.01) oesophageal acid exposure (9.25[4.7-15.4] vs. 3.3[1.4-7.4] vs. 0.7[0-2.4.2]), number of acid (45[23-55] vs. 32[19-44] vs. 18[10-31]), weakly-acidic (34[19-43] vs. 21[11-33]) vs. 18[15-28]) and proximal reflux events (51[26.5-65.5] vs. 20[9.5-34.5] vs. 9[5-20]) compared to non-IPF patients and HVs. Pulmonary fibrosis HRCT-scores correlated well with reflux episodes in both distal (r2=0.567) and proximal (r2=0.6323) oesophagus. Patients with IPF had more bile acids and pepsin (p<0.03) in broncho-alveolar lavage (BAL) (62%/67%) and saliva (61%/68%) than non-IPF patients (25%/25% in BAL, 33%/36% in saliva) and controls (0%/0% in BAL/saliva).Acid GOR is common in IPF, but weakly-acidic GOR may also occur. Patients with IPF have risk or definite pulmonary aspiration of gastric contents. Outcome studies with intense anti-reflux therapy are needed.
Authors:
Edoardo Savarino; Roberto Carbone; Elisa Marabotto; Manuele Furnari; Luca Sconfienza; Massimo Ghio; Patrizia Zentilin; Vincenzo Savarino
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-7
Journal Detail:
Title:  The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology     Volume:  -     ISSN:  1399-3003     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Dept of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy.
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