Prevalence of gastroesophageal reflux in end-stage lung disease candidates for lung transplant.
BACKGROUND
Aspiration secondary to gastroesophageal reflux has been postulated to be a contributing factor in bronchiolitis obliterans after lung transplantation. It is not clear whether gastroesophageal reflux is a preexisting condition or secondary to intraoperative vagal injury or drug-induced prolonged gastric emptying.


METHODS
The prevalence of gastroesophageal reflux was examined in 78 consecutive end-stage lung disease patients assessed for lung transplantation: emphysema, 21; cystic fibrosis, 5; idiopathic pulmonary fibrosis, 26; scleroderma, 10; and miscellaneous diseases, 16. All underwent esophageal manometry. Two-channel esophageal 24-hour pH testing was completed in 76 patients. Gastric emptying studies were conducted in 36 patients.


RESULTS
Typical gastroesophageal reflux symptoms were documented in 63% of patients. The lower esophageal sphincter was hypotensive in 72% of patients, and 33% had esophageal body dysmotility. Prolonged gastric emptying was documented in 44%, and 38% had abnormal pH testing. The overall DeMeester score was above normal in 32% of patients, and 20% had abnormal proximal pH probe readings.


CONCLUSIONS
Gastroesophageal reflux is highly prevalent in end-stage lung disease patients who are candidates for lung transplantation. Further investigation is needed to study the prevalence of gastroesophageal reflux after lung transplantation and its contribution to chronic allograft dysfunction.
D'Ovidio
Frank
F
Toronto Lung Transplant Program, University of Toronto, Toronto, Ontario, Canada. s.keshavjee@utoronto.ca
Singer
Lianne G
LG
Hadjiliadis
Denis
D
Pierre
Andrew
A
Waddell
Thomas K
TK
de Perrot
Marc
M
Hutcheon
Micheal
M
Miller
Linda
L
Darling
Gail
G
Keshavjee
Shaf
S
D000328:Adult; D000368:Aged; D001989:Bronchiolitis Obliterans / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D004947:Esophagus / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008171:Lung Diseases / Q000453:epidemiology* / Q000601:surgery*; D016040:Lung Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009929:Organ Size; D011187:Posture; D015995:Prevalence; D018570:Risk Assessment