Gastroesophageal reflux and pulmonary fibrosis in scleroderma: a study using pH-impedance monitoring
| Autor: | Daniel Pohl, Patrizia Zentilin, Edoardo Savarino, Marco Bazzica, Radu Tutuian, Simone Negrini, Giuseppe Cittadini, Francesco Indiveri, Andrea Parodi, Massimo Ghio, Vincenzo Savarino |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Esophageal pH Monitoring Pulmonary Fibrosis Critical Care and Intensive Care Medicine Gastroenterology Scleroderma Young Adult Esophagus Intensive care Internal medicine Pulmonary fibrosis Electric Impedance medicine Humans Prospective Studies skin and connective tissue diseases Aged Scleroderma Systemic integumentary system medicine.diagnostic_test Esophageal disease business.industry Respiratory disease Reflux Interstitial lung disease Middle Aged respiratory system medicine.disease Respiratory Function Tests Surgery Case-Control Studies Gastroesophageal Reflux Female Tomography X-Ray Computed Esophageal pH monitoring business |
| Popis: | Interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) is associated with increased morbidity and mortality. Gastroesophageal reflux (GER) is considered a contributing factor in the pathogenesis of ILD.To characterize GER (acid and nonacid) in patients with SSc with and without ILD.Patients with SSc underwent pulmonary high-resolution computer tomography (HRCT) scan and 24-hour impedance-pH monitoring off-proton pump inhibitor therapy. The presence of pulmonary fibrosis was assessed using validated HRCT-scores. Reflux monitoring parameters included number of acid and nonacid reflux episodes, proximal migration of the refluxate, and distal esophageal acid exposure. Unless otherwise specified, data are presented as median (25th-75th percentile).Forty consecutive patients with SSc (35 female; mean age, 53 yr; range, 24-71; 15 patients with diffuse and 25 with limited SSc) were investigated; 18 (45%) patients with SSc had pulmonary fibrosis (HRCT scoreor= 7). Patients with SSc with ILD had higher (P0.01) esophageal acid exposure (10.3 [7.5-15] vs. 5.2 [1.5-11]), higher (P0.01) number of acid (41 [31-58] vs. 19 [10-23]) and nonacid (25 [20-35] vs. 17 [11-19]) reflux episodes, and higher (P0.01) number of reflux episodes reaching the proximal esophagus (42.5 [31-54] vs. 15 [8-22]) compared with patients with SSc with normal HRCT scores. Pulmonary fibrosis scores (HRCT score) correlated well with the number of reflux episodes in the distal (r(2) = 0.637) and proximal (r(2) = 0.644) esophagus.Patients with SSc with ILD have more severe reflux (i.e., more reflux episodes and more reflux reaching the proximal esophagus). Whether or not the development of ILD in patients with SSc can be prevented by reflux-reducing treatments needs to be investigated. |
| Databáze: | OpenAIRE |
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