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Severe gastroesophageal reflux is associated with reduced carbon monoxide diffusing capacity
Linda M Schachter1, John Dixon, Robert J Pierce
1Institute for Breathing and Sleep, Austin and Repatriation Medical Centre, Heidelberg, VIC, Australia. lindams@bigpond.com
Chest
|June 11, 2003
Summary
Severe gastroesophageal reflux (GER) significantly impairs lung gas exchange, specifically the diffusing capacity of the lung for carbon monoxide (DLCO). This finding suggests potential airway irritation from gastric acid or fluid microaspiration in patients with GER.
Area of Science:
- Pulmonology
- Gastroenterology
- Internal Medicine
Background:
- Gastroesophageal reflux (GER) is a common condition with potential extra-esophageal manifestations.
- Obesity is a significant risk factor for GER and can also impact lung function independently.
Purpose of the Study:
- To investigate the association between severe GER and lung function abnormalities.
- To specifically assess measures of lung volume and gas diffusion in patients with severe GER.
Main Methods:
- Retrospective analysis of 147 patients with obesity undergoing surgery.
- Preoperative questionnaires assessed GER history, symptoms, and risk factors (lung disease, sleep apnea, smoking).
- GER severity was graded by a blinded physician using pH monitoring/gastroscopy and medication use; spirometry, lung volumes, and gas transfer (DLCO) were measured.
Main Results:
- Patients with severe GER exhibited significantly reduced diffusing capacity of the lung for carbon monoxide (DLCO) compared to those without GER (p=0.001).
- Gas transfer corrected for lung volume was also significantly lower in the severe GER group (p=0.001).
- No significant differences were observed in other lung function parameters.
Conclusions:
- Severe GER is linked to impaired pulmonary gas exchange.
- Microaspiration of gastric contents into the airways is a potential mechanism for this lung dysfunction.