Radiographic pulmonary changes of gastro-oesophageal reflux disease in elderly patients

The aim of this study was to investigate the association of gastro-oesophageal reflux disease (GORD) with radiographic pulmonary changes. One hundred and thirty-seven patients aged over 60 years referred for endoscopy for abdominal symptoms were included in the study. In patients with any suspicion of GORD (n = 95), 24-hour oesophageal pH monitoring was carried out. All the patients were interviewed before the examinations. Chest radiography was performed in all patients. Odds ratio of respiratory symptoms was 8.7 (95% confidence interval 3.4-22.4) in patients with total reflux time of more than 10% compared with those who had total reflux time of less than 10%. In chest radiography, bilateral pleural adhesions and thickenings and bilateral parenchymal scars were significantly more common in patients with, than in those without, regurgitation or large hiatal openings. The occurrence of bilateral scars and pleural thickenings increased with the extent of gastro-oesophageal reflux in pH monitoring. Odds ratios of bilateral pleural thickening and pulmonary scars were 3.1 (95% confidence interval 0.8-11.5) and 5.8 (1.1-29.6) in patients with total reflux time over 10%, compared with patients who had normal total reflux time. The findings indicate that respiratory involvement is a characteristic feature of GORD in elderly patients.