Skip to main content

GER and Aspiration in Interstitial Lung Disease

  • Chapter
  • First Online:
Gastroesophageal Reflux and the Lung

Part of the book series: Respiratory Medicine ((RM,volume 2))

Abstract

Many investigations have linked gastroesophageal reflux (GER) to various forms of interstitial lung disease (ILD) including idiopathic pulmonary fibrosis (IPF), scleroderma, and other connective tissue diseases (CTD). However, definitive proof that abnormal GER and microaspiration is a cause of ILD, promotes disease progression, or precipitates acute exacerbation of IPF or other forms of ILD is lacking. Nonetheless, evidence is accumulating that suggests that abnormal GER and microaspiration of refluxed gastroduodenal secretions may play a significant role in IPF, scleroderma, and other ILD. This chapter examines the published evidence and provides an assessment of the current state of knowledge of the role of GER and microaspiration in ILD.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tobin RW, Pope II CE, Pellegrini CA, Emond MJ, Sillery J, Raghu G. Increased prevalence of gastroesophageal reflux in patients with idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 1998;158:1804–8.

    CAS  PubMed  Google Scholar 

  2. Lee JS, Ryu JH, Elicker BM, Lydell CP, Jones KD, Wolters PJ, et al. Gastroesophageal reflux therapy is associated with longer survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2011;184:1390–4.

    Article  PubMed  Google Scholar 

  3. Savarino E, Bazzica M, Zentilin P, Pohl D, Parodi A, Cittadini G, et al. Gastroesophageal reflux and pulmonary fibrosis in scleroderma: a study using pH-impedance monitoring. Am J Respir Crit Care Med. 2009;179:408–13.

    Article  PubMed  Google Scholar 

  4. Christmann RB, Wells AU, Capelozzi VL, Silver RM. Gastroesophageal reflux incites interstitial lung disease in systemic sclerosis: clinical, radiologic, histopathologic, and treatment evidence. Semin Arthritis Rheum. 2010;40:241–9.

    Article  PubMed  Google Scholar 

  5. Patti MG, Gasper WJ, Fisichella PM, Nipomnick I, Palazzo F. Gastroesophageal reflux disease and connective tissue disorders: pathophysiology and implications for treatment. J Gastrointest Surg. 2008;12:1900–6.

    Article  PubMed  Google Scholar 

  6. Soares RV, Forsythe A, Hogarth K, Sweiss NJ, Noth I, Patti MG. Interstitial lung disease and gastroesophageal reflux disease: key role of esophageal function tests in the diagnosis and treatment. Arq Gastroenterol. 2011;48:91–7.

    Article  PubMed  Google Scholar 

  7. Morehead RS. Gastro-oesophageal reflux disease and non-asthma lung disease. Eur Respir Rev. 2009;18:233–43.

    Article  CAS  PubMed  Google Scholar 

  8. Locke 3rd GR, Talley NJ, Fett SL, Zinsmeister AR, Melton 3rd LJ. Risk factors associated with symptoms of gastroesophageal reflux. Gastroenterology. 1997;112:1448–56.

    Article  PubMed  Google Scholar 

  9. Swigris JJ, Brown KK, Flaherty KR. The idiopathic interstitial pneumonias and connective tissue disease-associated interstitial lung disease. Curr Rheumatol Rev. 2010;6:91–8.

    Article  Google Scholar 

  10. Leslie KO. Pathology of interstitial lung disease. Clin Chest Med. 2004;25:657–703.

    Article  PubMed  Google Scholar 

  11. Kandulski A, Malfertheiner P. Gastroesophageal reflux disease-from reflux episodes to mucosal inflammation. Nat Rev Gastroenterol Hepatol. 2011;9:15–22.

    Article  PubMed  CAS  Google Scholar 

  12. Gleeson K, Eggli DF, Maxwell SL. Quantitative aspiration during sleep in normal subjects. Chest. 1997;111:1266–72.

    Article  CAS  PubMed  Google Scholar 

  13. Kahrilas PJ, Dodds WJ, Dent J, Haeberle B, Hogan WJ, Arndorfer RC. Effect of sleep, spontaneous gastroesophageal reflux, and a meal on upper esophageal sphincter pressure in normal human volunteers. Gastroenterology. 1987;92:466–71.

    CAS  PubMed  Google Scholar 

  14. Marik PE. Aspiration pneumonitis and aspiration pneumonia. New Engl J Med. 2001;344:665–71.

    Article  CAS  PubMed  Google Scholar 

  15. Barnes TW, Vassallo R, Tazelaar HD, Hartman TE, Ryu JH. Diffuse bronchiolar disease due to chronic occult aspiration. Mayo Clin Proc. 2006;81:172–6.

    Article  PubMed  Google Scholar 

  16. Poh CH, Navarro-Rodrigues T, Fass R. Treatment of gastroesophageal reflux disease in the elderly. Am J Med. 2010;123:496–501.

    Article  PubMed  Google Scholar 

  17. Plant RL. Anatomy and physiology of swallowing in adults and geriatrics. Otolaryngol Clin North Am. 1998;31:447–88.

    Google Scholar 

  18. Khajanchee YS, Urbach DR, Butler N, Hansen PD, Swanstrom LL. Laparoscopic antireflux surgery in the elderly. Surg Endosc. 2002;16:25–30.

    Article  CAS  PubMed  Google Scholar 

  19. Patti MG, Goldberg HI, Arcerito M, Bortolasi L, Tong J, Way LW. Hiatal hernia size affects lower esophageal sphincter function, esophageal acid exposure, and the degree of mucosal injury. Am J Surg. 1996;171:182–6.

    Article  CAS  PubMed  Google Scholar 

  20. Pilotto A, Franceschi M, Leandro G, Scarcelli C, D’Ambrosio LP, Seripa D, et al. Clinical features of reflux esophagitis in older people: a study of 840 consecutive patients. J Am Geriatr Soc. 2006;54:1537–42.

    Article  PubMed  Google Scholar 

  21. Hamelberg W, Bosomworth PP. Aspiration pneumonitis: experimental studies and clinical observations. Anesth Analg. 1964;43:669–77.

    CAS  PubMed  Google Scholar 

  22. Teabeaut 2nd JR. Aspiration of gastric contents: an experimental study. Am J Pathol. 1952;28:51–67.

    PubMed  Google Scholar 

  23. Greenfield LJ, Singleton RP, McCaffree DR, Coalson JJ. Pulmonary effects of experimental graded aspiration of hydrochloric acid. Ann Surg. 1969;170:74–86.

    Article  CAS  PubMed  Google Scholar 

  24. Glauser FL, Millen JE, Falls R. Increased alveolar epithelial permeability with acid aspiration: the effects of high-dose steroids. Am Rev Respir Dis. 1979;120:1119–23.

    CAS  PubMed  Google Scholar 

  25. Schwartz DJ, Wynne JW, Gibbs CP, Hood CI, Kuck EJ. The pulmonary consequences of aspiration of gastric contents at H values greater than 2.5. Am Rev Respir Dis. 1980;121:119–26.

    CAS  PubMed  Google Scholar 

  26. Stothert JC, Weaver LJ, Carrico CJ. Lung albumin content after acid aspiration pulmonary injury. J Surg Res. 1981;30:256–61.

    Article  CAS  PubMed  Google Scholar 

  27. Popper H, Juettner F, Pinter J. The gastric juice aspiration syndrome (Mendelson syndrome). Aspects of pathogenesis and treatment in the pig. Virchows Arch A Pathol Anat Histopathol. 1986;409:105–17.

    Article  CAS  PubMed  Google Scholar 

  28. Appel 3rd JZ, Lee SM, Hartwig MG, Li B, Hsieh CC, Cantu 3rd E, et al. Characterization of the innate immune response to chronic aspiration in a novel rodent model. Respir Res. 2007;8:87.

    Article  PubMed  CAS  Google Scholar 

  29. Amigoni M, Bellani G, Scanziani M, Masson S, Bertoli E, Radaelli E, et al. Lung injury and recovery in a murine model of unilateral acid aspiration: functional, biochemical, and morphologic characterization. Anesthesiology. 2008;108:1037–46.

    Article  CAS  PubMed  Google Scholar 

  30. Mitsuhashi T, Shimazaki M, Chanoki Y, Kuwahara H, Sakai T, Masuda H. Experimental pulmonary fibrosis induced by trisodium citrate and acid-citrate-dextrose. Exp Mol Pathol. 1985;42:261–70.

    Article  CAS  PubMed  Google Scholar 

  31. Kwan M, Xu YD, Raghu G, Khalil N. Acid treatment of normal rat lungs releases transforming growth factor-beta1 (TGF-beta1) and increased connective tissue synthesis. Am J Respir Crit Care Med. 2007:175 A967.

    Google Scholar 

  32. Downing TE, Sporn TA, Bollinger RR, Davis RD, Parker W, Lin SS. Pulmonary histopathology in an experimental model of chronic aspiration is independent of acidity. Exp Biol Med (Maywood). 2008;233:1202–12.

    Article  CAS  Google Scholar 

  33. Meers CM, De Wever W, Verbeken E, Mertens V, Wauters S, De Vleeschauwer SI, et al. A porcine model of acute lung injury by instillation of gastric fluid. J Surg Res. 2011;166:e195–204.

    Article  PubMed  Google Scholar 

  34. Wang K, Lin HJ, Perng CL, Tseng GY, Yu KW, Chang FY, et al. The effect of H2-receptor antagonist and proton pump inhibitor on microbial proliferation in the stomach. Hepatogastroenterology. 2004;51:1540–3.

    CAS  PubMed  Google Scholar 

  35. D’Ovidio F, Mura M, Ridsdale R, Takahashi H, Waddell TK, Hutcheon M, et al. The effect of reflux and bile acid aspiration on the lung allograft and its surfactant and innate immunity molecules SP-A and SP-D. Am J Transplant. 2006;6:1930–8.

    Article  PubMed  CAS  Google Scholar 

  36. Perng DW, Chang KT, Su KC, Wu YC, Wu MT, Hsu WH, et al. Exposure of airway epithelium to bile acids associated with gastroesophageal reflux symptoms: a relation to transforming growth factor-beta1 production and fibroblast proliferation. Chest. 2007;132:1548–56.

    Article  CAS  PubMed  Google Scholar 

  37. Mertens V, Blondeau K, Vanaudenaerde B, Vos R, Farre R, Pauwels A, et al. Gastric juice from patients “on” acid suppressive therapy can still provoke a significant inflammatory reaction by human bronchial epithelial cells. J Clin Gastroenterol. 2010;44:e230–5.

    Article  CAS  PubMed  Google Scholar 

  38. Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011;183:788–824.

    Article  PubMed  Google Scholar 

  39. Meyer KC. Interstitial lung disease in the elderly: pathogenesis, diagnosis and management. Sarcoidosis Vasc Diffuse Lung Dis. 2011;28:3–17.

    CAS  PubMed  Google Scholar 

  40. Raghu G, Weycker D, Edelsberg J, Bradford WZ, Oster G. Incidence and prevalence of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2006;174:810–6.

    Article  PubMed  Google Scholar 

  41. Selman M, Rojas M, Mora AL, Pardo A. Aging and interstitial lung diseases: unraveling an old forgotten player in the pathogenesis of lung fibrosis. Semin Respir Crit Care Med. 2010;31:607–17.

    Article  PubMed  Google Scholar 

  42. King Jr TE, Pardo A, Selman M. Idiopathic pulmonary fibrosis. Lancet. 2011;378:1949–61.

    Article  PubMed  Google Scholar 

  43. Collins K, Mitchell JR. Telomerase in the human organism. Oncogene. 2002;21:564–79.

    Article  CAS  PubMed  Google Scholar 

  44. Liu T, Hu B, Chung MJ, Ullenbruch M, Jin H, Phan SH. Telomerase regulation of myofibroblast differentiation. Am J Respir Cell Mol Biol. 2006;34:625–33.

    Article  CAS  PubMed  Google Scholar 

  45. Armanios MY, Chen JJ, Cogan JD, Alder JK, Ingersoll RG, Markin C, et al. Telomerase mutations in families with idiopathic pulmonary fibrosis. New Engl J Med. 2007;356:1317–26.

    Article  CAS  PubMed  Google Scholar 

  46. Tsakiri K, Cronkhite JT, Kuan PJ, Xing C, Raghu G, Weissler JC, et al. Adult-onset pulmonary fibrosis caused by mutations in telomerase. Proc Natl Acad Sci. 2007;104:7552–7.

    Article  CAS  PubMed  Google Scholar 

  47. Mora AL, Rojas M. Aging and lung injury repair: a role for bone marrow derived mesenchymal stem cells. J Cell Biochem. 2008;105:641–7.

    Article  CAS  PubMed  Google Scholar 

  48. Ruzankina Y, Asare A, Brown EJ. Replicative stress, stem cells and aging. Mech Ageing Dev. 2008;129:460–6.

    Article  CAS  PubMed  Google Scholar 

  49. Collard HR, King Jr TE. Demystifying idiopathic interstitial pneumonia. Arch Intern Med. 2003;163:17–29.

    Article  PubMed  Google Scholar 

  50. Nathan SD, Shlobin OA, Weir N, Ahmad S, Kaldjob JM, Battle E, et al. Long-term course and prognosis of idiopathic pulmonary fibrosis in the new millennium. Chest. 2011;140:221–9.

    Article  PubMed  Google Scholar 

  51. Martinez FJ, Safrin S, Weycker D, Starko KM, Bradford WZ, King Jr TE, et al. The clinical course of patients with idiopathic pulmonary fibrosis. Ann Intern Med. 2005;142:963–7.

    PubMed  Google Scholar 

  52. Collard HR, Moore BB, Flaherty KR, Brown KK, Kaner RJ, King Jr TE, et al. Acute exacerbations of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2007;176:636–43.

    Article  PubMed  Google Scholar 

  53. Pearson JE, Wilson RS. Diffuse pulmonary fibrosis and hiatus hernia. Thorax. 1971;26:300–5.

    Article  CAS  PubMed  Google Scholar 

  54. Mays EE, Dubois JJ, Hamilton GB. Pulmonary fibrosis associated with tracheobronchial aspiration. A study of the frequency of hiatal hernia and gastroesophageal reflux in interstitial pulmonary fibrosis of obscure etiology. Chest. 1976;69:512–5.

    Article  CAS  PubMed  Google Scholar 

  55. Raiha I, Manner R, Hietanen E. Radiographic pulmonary changes of gastro-esophageal reflux disease in elderly patients. Age Ageing. 1992;21:250–5.

    Article  CAS  PubMed  Google Scholar 

  56. El-Serag HB, Sonnenberg A. Comorbid occurrence of laryngeal or pulmonary disease with esophagitis in United States military veterans. Gastroenterology. 1997;113:755–60.

    Article  CAS  PubMed  Google Scholar 

  57. Patti MG, Tedesco P, Golden J, Hays S, Hoopes C, Meneghetti A, et al. Idiopathic pulmonary fibrosis: how often is it really idiopathic? J Gastrointest Surg. 2005;9:1053–6.

    Article  PubMed  Google Scholar 

  58. Raghu G, Freudenberger TD, Yang S, Curtis JR, Spada C, Hayes J, et al. High prevalence of abnormal acid reflux in idiopathic pulmonary fibrosis. Eur Respir J. 2006;27:136–42.

    Article  CAS  PubMed  Google Scholar 

  59. Salvioli B, Belmonte G, Stanghellini V, Baldi E, Fasano L, Pacilli AM, et al. Gastro-oesophageal reflux and interstitial lung disease. Dig Liver Dis. 2006;38:879–84.

    Article  CAS  PubMed  Google Scholar 

  60. Raghu G, Yang ST, Spada C, Hayes J, Pellegrini CA. Sole treatment of acid gastroesophageal reflux in idiopathic pulmonary fibrosis: a case series. Chest. 2006;129:794–800.

    Article  PubMed  Google Scholar 

  61. Linden PA, Gilbert RJ, Yeap BY, Boyle K, Deykin A, Jaklitsch MT, et al. Laparoscopic fundoplication in patients with end-stage lung disease awaiting transplantation. J Thorac Cardiovasc Surg. 2006;131:438–46.

    Article  PubMed  Google Scholar 

  62. Sweet MP, Patti MG, Leard LE, Golden JA, Hays SR, Hoopes C, et al. Gastroesophageal reflux in patients with idiopathic pulmonary fibrosis referred for lung transplantation. J Thorac Cardiovasc Surg. 2007;133:1078–84.

    Article  PubMed  Google Scholar 

  63. Noth I, Zangan SM, Soares RV, Forsythe A, Demchuk C, Takahashi SM, et al. Prevalence of hiatal hernia by blinded MDCT in patients with IPF. Eur Respir J. 2012;39(2):344–51.

    Article  CAS  PubMed  Google Scholar 

  64. Lee JS, Song JW, Wolters PJ, Elicker BM, King Jr TE, Kim DS, Collard HR. Bronchoalveolar lavage pepsin in acute exacerbation of idiopathic pulmonary fibrosis. Eur Respir J. 2012;39(2):352–8.

    Article  CAS  PubMed  Google Scholar 

  65. Derk CT, Jimenez SA. Systemic sclerosis: current views of its pathogenesis. Autoimmun Rev. 2003;2:181–91.

    Article  CAS  PubMed  Google Scholar 

  66. Sjogren RW. Gastrointestinal motility disorders in scleroderma. Arthritis Rheum. 1994;37:1265–82.

    Article  CAS  PubMed  Google Scholar 

  67. McCarthy DS, Baragar FD, Dhingra S, Sigurdson M, Sutherland JB, Rigby M, et al. The lungs in systemic sclerosis (scleroderma): a review and new information. Semin Arthritis Rheum. 1988;17:271–83.

    Article  CAS  PubMed  Google Scholar 

  68. Johnson DA, Drane WE, Curran J, Cattau Jr EL, Ciarleglio C, Khan A, et al. Pulmonary disease in progressive systemic sclerosis. A complication of gastroesophageal reflux and occult aspiration? Arch Intern Med. 1989;149:589–93.

    Article  CAS  PubMed  Google Scholar 

  69. Fagundes MN, Caleiro MT, Navarro-Rodriguez T, Baldi BG, Kavakama J, Salge JM, et al. Esophageal involvement and interstitial lung disease in mixed connective tissue disease. Respir Med. 2009;103:854–60.

    Article  CAS  PubMed  Google Scholar 

  70. Marie I, Dominique S, Levesque H, Ducrotté P, Denis P, Hellot MF, et al. Esophageal involvement and pulmonary manifestations in systemic sclerosis. Arthritis Rheum. 2001;45:346–54.

    Article  CAS  PubMed  Google Scholar 

  71. de Souza RB, Borges CT, Capelozzi VL, Parra ER, Jatene FB, Kavakama J, et al. Centrilobular fibrosis: an underrecognized pattern in systemic sclerosis. Respiration. 2009;77(4):389–97.

    Article  PubMed  Google Scholar 

  72. Patti MG, Debas HT, Pellegrini CA. Esophageal manometry and 24-hour pH monitoring in the diagnosis of pulmonary aspiration secondary to gastroesophageal reflux. Am J Surg. 1992;163:401–6.

    Article  CAS  PubMed  Google Scholar 

  73. Knoblich R. Pulmonary granulomatosis caused by vegetable particles. So-called lentil pulse pneumonia. Am Rev Respir Dis. 1969;99:380–9.

    CAS  PubMed  Google Scholar 

  74. Crome L, Valentine JC. Pulmonary nodular granulomatosis caused by inhaled vegetable particles. J Clin Pathol. 1962;15:21–5.

    Article  CAS  PubMed  Google Scholar 

  75. Vidyarthi SC. Diffuse military granulomatosis of the lungs due to aspirated vegetable cells. Arch Pathol. 1967;83:215–8.

    CAS  PubMed  Google Scholar 

  76. Emery JL. Two cases of lentil pneumonitis. Proc R Soc Med. 1960;53:952–3.

    CAS  PubMed  Google Scholar 

  77. Gill DG, Ritchie GJ. Lentil Pulmonary granulomatosis. Med J Aust. 1974;1:836–8.

    CAS  PubMed  Google Scholar 

  78. Friedlander AL, Fessler MB. A 70-year-old man with migratory pulmonary infiltrates. Chest. 2006;130:1269–74.

    Article  PubMed  Google Scholar 

  79. Epler GR. Bronchiolitis obliterans organizing pneumonia. Arch Intern Med. 2001;161:158–64.

    Article  CAS  PubMed  Google Scholar 

  80. Lazor R, Vandevenne A, Pelletier A, Leclerc P, Court-Fortune I, Cordier JF. Cryptogenic organizing pneumonia. Characteristics of relapses in a series of 48 patients. Am J Respir Crit Care Med. 2000;162:571–7.

    CAS  PubMed  Google Scholar 

  81. Drakopanagiotakis F, Polychronopoulos V, Judson MA. Organizing pneumonia. Am J Med Sci. 2008;335:34–9.

    Article  PubMed  Google Scholar 

  82. Sadoun D, Valeyre D, Cargill J, Volter F, Amouroux J, Battesti JP. Apparently cryptogenic bronchiolitis obliterans with organizing pneumonia. Demonstration of a gastro-oesophageal reflux in 5 cases. Presse Med. 1988;17:2383–5.

    CAS  PubMed  Google Scholar 

  83. Song JW, Hong SB, Lim CM, Koh Y, Kim DS. Acute exacerbation of idiopathic pulmonary fibrosis: incidence, risk factors and outcome. Eur Respir J. 2011;37:356–63.

    Article  CAS  PubMed  Google Scholar 

  84. Kondoh Y, Taniguchi H, Katsuta T, Kataoka K, Kimura T, Nishiyama O, et al. Risk factors of acute exacerbation of idiopathic pulmonary fibrosis. Sarcoidosis Vasc Diffuse Lung Dis. 2010;27:103–10.

    CAS  PubMed  Google Scholar 

  85. Wootton XC, Kim DS, Kondoh Y, Chen E, Lee JS, Song JW, et al. Viral infection in acute exacerbation of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2011;183:1698–702.

    Article  PubMed  Google Scholar 

  86. Daniels CE, Yi ES, Ryu JH. Autopsy findings in 42 consecutive patients with idiopathic pulmonary fibrosis. Eur Respir J. 2008;32:170–4.

    Article  CAS  PubMed  Google Scholar 

  87. Silva CI, Müller NL, Fujimoto K, Kato S, Ichikado K, Taniguchi H, et al. Acute exacerbation of chronic interstitial pneumonia: high-resolution computed tomography and pathologic findings. J Thorac Imaging. 2007;22:221–9.

    Article  PubMed  Google Scholar 

  88. Park IN, Kim DS, Shim TS, Lim CM, Lee SD, Koh Y, et al. Acute exacerbation of interstitial pneumonia other than idiopathic pulmonary fibrosis. Chest. 2007;132:214–20.

    Article  PubMed  Google Scholar 

  89. Emerenziani S, Sifrim D. New developments in detection of gastroesophageal reflux. Curr Opin Gastroenterol. 2005;21:450–3.

    PubMed  Google Scholar 

  90. Lee JS, Collard HR, Raghu G, Sweet MP, Hays SR, Campos GM, et al. Does chronic microaspiration cause idiopathic pulmonary fibrosis? Am J Med. 2010;123(4):304–11.

    Article  PubMed  Google Scholar 

  91. Stoeckli SJ, Huisman TA, Seifert B, Martin-Harris BJ. Interrater reliability of videofluoroscopic swallow evaluation. Dysphagia. 2003;18:53–7.

    Article  PubMed  Google Scholar 

  92. Ravelli AM, Panarotto MB, Verdoni L, Consolati V, Bolognini S. Pulmonary aspiration shown by scintigraphy in gastroesophageal reflux-related respiratory disease. Chest. 2006;130:1520–6.

    Article  PubMed  Google Scholar 

  93. Crausaz FM, Favez G. Aspiration of solid food particles into lungs of patients with gastroesophageal reflux and chronic bronchial disease. Chest. 1988;93:376–8.

    Article  CAS  PubMed  Google Scholar 

  94. Schraufnagel DE, Michel JC, Sheppard TJ, Saffold PC, Kondos GT. CT of the normal esophagus to define the normal air column and its extent and distribution. Am J Roentgenol. 2008;191:748–52.

    Article  Google Scholar 

  95. Ginalski JM, Schnyder P, Moss AA, Brasch RC. Incidence and significance of a widened esophageal hiatus at CT scan. J Clin Gastroenterol. 1984;6:467–70.

    Article  CAS  PubMed  Google Scholar 

  96. Tutuian R. Update in the diagnosis of gastroesophageal reflux disease. J Gastrointestin Liver Dis. 2006;15:243–7.

    PubMed  Google Scholar 

  97. Kahrilas PJ, Sifrim D. High-resolution manometry and impedance-pH/manometry: valuable tools in clinical and investigational esophagology. Gastroenterology. 2008;135:756–69.

    Article  PubMed  Google Scholar 

  98. Oelschlager BK, Chang L, Pope 2nd CE, Pellegrini CA. Typical GERD symptoms and esophageal pH monitoring are not enough to diagnose pharyngeal reflux. J Surg Res. 2005;128:55–60.

    Article  PubMed  Google Scholar 

  99. Metheny NA, Chang YH, Ye JS, Edwards SJ, Defer J, Dahms TE, et al. Pepsin as a marker for pulmonary aspiration. Am J Crit Care. 2002;11:150–4.

    PubMed  Google Scholar 

  100. Farrell S, McMaster C, Gibson D, Shields MD, McCallion WA. Pepsin in bronchoalveolar lavage fluid: a specific and sensitive method of diagnosing gastrooesophageal reflux-related pulmonary aspiration. J Pediatr Surg. 2006;41:289–93.

    Article  PubMed  Google Scholar 

  101. Potluri S, Friedenberg F, Parkman HP, Chang A, MacNeal R, Manus C, et al. Comparison of a salivary/sputum pepsin assay with 24-hour esophageal pH monitoring for detection of gastric reflux into the proximal esophagus, oropharynx, and lung. Dig Dis Sci. 2003;48:1813–7.

    Article  CAS  PubMed  Google Scholar 

  102. Ufberg JW, Bushra JS, Patel D, Wong E, Karras DJ, Kueppers F. A new pepsin assay to detect pulmonary aspiration of gastric contents among newly intubated patients. Am J Emerg Med. 2004;22:612–4.

    Article  PubMed  Google Scholar 

  103. Starosta V, Kitz R, Hartl D, Marcos V, Reinhardt D, Griese M. Bronchoalveolar pepsin, bile acids, oxidation, and inflammation in children with gastroesophageal reflux disease. Chest. 2007;132:1557–64.

    Article  CAS  PubMed  Google Scholar 

  104. Stovold R, Forrest IA, Corris PA, Murphy DM, Smith JA, Decalmer S, et al. Pepsin, a biomarker of gastric aspiration in lung allografts: a putative association with rejection. Am J Respir Crit Care Med. 2007;175:1298–303.

    Article  CAS  PubMed  Google Scholar 

  105. Horvath I, Hunt J, Barnes PJ, Alving K, Antczak A, Baraldi E, et al. Exhaled breath condensate: methodological recommendations and unresolved questions. Eur Respir J. 2005;26:523–48.

    Article  CAS  PubMed  Google Scholar 

  106. Psathakis K, Mermigkis D, Papatheodorou G, Loukides S, Panagou P, Polychronopoulos V, et al. Exhaled markers of oxidative stress in idiopathic pulmonary fibrosis. Eur J Clin Invest. 2006;36:362–7.

    Article  CAS  PubMed  Google Scholar 

  107. Hunt J. Exhaled breath condensate: an overview. Immunol Allergy Clin North Am. 2007;27:587–96.

    Article  PubMed  Google Scholar 

  108. Jackson AS, Sandrini A, Campbell C, Chow S, Thomas PS, Yates DH. Comparison of biomarkers in exhaled breath condensate and bronchoalveolar lavage. Am J Respir Crit Care Med. 2007;175:222–7.

    Article  CAS  PubMed  Google Scholar 

  109. Gulmez SE, Holm A, Frederiksen H, Jensen TG, Pedersen C, Hallas J. Use of proton pump inhibitors and the risk of community-acquired pneumonia: a population-based case-control study. Arch Intern Med. 2007;167:950–5.

    Article  CAS  PubMed  Google Scholar 

  110. Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. 2006;296:2947–53.

    Article  CAS  PubMed  Google Scholar 

  111. Cantu E, Appel JZ, Hartwig MG, et al. J. Maxwell Chamberlain Memorial Paper. Early fundoplication prevents chronic allograft dysfunction in patients with gastroesophageal reflux disease. Ann Thorac Surg. 2004;78:1142–51.

    Article  PubMed  Google Scholar 

  112. Davis Jr RD, Lau CL, Eubanks S, Messier RH, Hadjiliadis D, Steele MP, et al. Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation. J Thorac Cardiovasc Surg. 2003;125:533–42.

    Article  PubMed  Google Scholar 

  113. DeVault KR, Castell DO. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2005;100:190–200.

    Article  PubMed  Google Scholar 

  114. Sise A, Friedenberg FK. A comprehensive review of gastroesophageal reflux disease and obesity. Obes Rev. 2008;9:194–203.

    Article  CAS  PubMed  Google Scholar 

  115. Lancaster LH, Mason WR, Parnell JA, Rice TW, Loyd JE, Milstone AP, et al. Obstructive sleep apnea is common in idiopathic pulmonary fibrosis. Chest. 2009;136:772–8.

    Article  PubMed  Google Scholar 

  116. Tawk M, Goodrich S, Kinasewitz G, Orr W. The effect of 1 week of continuous positive airway pressure treatment in obstructive sleep apnea patients with concomitant gastroesophageal reflux. Chest. 2006;130:1003–8.

    Article  PubMed  Google Scholar 

  117. O’Halloran EK, Reynolds JD, Lau CL, Manson RJ, Davis RD, Palmer SM, et al. Laparoscopic Nissen fundoplication for treating reflux in lung transplant recipients. J Gastrointest Surg. 2004;8:132–7.

    Article  PubMed  Google Scholar 

  118. Sugarbaker DJ, Bueno R. Laparoscopic fundoplication in patients with end-stage disease awaiting transplantation. J Thorac Cardiovasc Surg. 2006;131:438–46.

    Article  PubMed  Google Scholar 

  119. Gasper WJ, Sweet MP, Hoopes C, Leard LE, Kleinhenz ME, Hays SR, et al. Antireflux surgery for patients with end-stage lung disease before and after lung transplantation. Surg Endosc. 2008;22:495–500.

    Article  CAS  PubMed  Google Scholar 

  120. Gasper WJ, Sweet MP, Golden JA, Hoopes C, Leard LE, Kleinhenz ME, et al. Lung transplantation in patients with connective tissue disorders and esophageal dysmotility. Dis Esophagus. 2008;21:650–5.

    Article  PubMed  Google Scholar 

  121. Raghu G, Meyer KC. Silent gastro-oesophageal reflux and microaspiration in IPF: mounting evidence for anti-reflux therapy? Eur Respir J. 2012;39(2):242–5.

    Article  CAS  PubMed  Google Scholar 

  122. Raghu G. Idiopathic pulmonary fibrosis: increased survival with “gastroesophageal reflux therapy”: fact or fallacy? Am J Respir Crit Care Med. 2011;184(12):1330–2.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Keith C. Meyer M.D., M.S. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media New York

About this chapter

Cite this chapter

Meyer, K.C., Raghu, G. (2012). GER and Aspiration in Interstitial Lung Disease. In: Meyer, K., Raghu, G. (eds) Gastroesophageal Reflux and the Lung. Respiratory Medicine, vol 2. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-5502-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-5502-8_10

  • Published:

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4614-5501-1

  • Online ISBN: 978-1-4614-5502-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics