The Prevalence of Gastroesophageal Reflux in Patients With Excessive Central Airway Collapse

Chest. 2019 Mar;155(3):540-545. doi: 10.1016/j.chest.2018.09.021. Epub 2018 Oct 9.

Abstract

Background: Gastroesophageal reflux (GER) is increasingly recognized as an exacerbating or causal factor in several respiratory diseases. There is a high prevalence of GER in infants with airway malacia. However, such data are lacking in adults.

Methods: This retrospective study was conducted to determine the relationship between GER and excessive central airway collapse (ECAC). The study included consecutive patients with ECAC referred to the Complex Airway Center at Beth Israel Deaconess Medical Center who underwent esophageal pH testing for GER between July 2014 and June 2018.

Results: Sixty-three of 139 patients with ECAC (45.3%) had documented GER as shown by an abnormal esophageal pH test result. The mean DeMeester score was 32.2, with a symptom association probability of 39.7% of GER-positive patients. Twenty-nine of 63 patients (46%) with GER reported improvement in respiratory symptoms following maximal medical therapy or antireflux surgery without requiring further treatment for ECAC.

Conclusions: GER is prevalent among patients with ECAC, and aggressive reflux treatment should be considered in these patients prior to considering invasive airway procedures or surgery.

Keywords: excessive central airway collapse; excessive dynamic airway collapse; gastroesophageal reflux; tracheobronchomalacia.

MeSH terms

  • Bronchoscopy / methods
  • Bronchoscopy / statistics & numerical data
  • Comorbidity
  • Esophageal pH Monitoring / methods*
  • Esophageal pH Monitoring / statistics & numerical data
  • Female
  • Gastroesophageal Reflux* / diagnosis
  • Gastroesophageal Reflux* / epidemiology
  • Gastroesophageal Reflux* / physiopathology
  • Gastroesophageal Reflux* / therapy
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Respiratory System / pathology
  • Respiratory System / physiopathology
  • Retrospective Studies
  • Severity of Illness Index
  • Tomography, X-Ray Computed / methods
  • Tomography, X-Ray Computed / statistics & numerical data
  • Tracheobronchomalacia* / diagnosis
  • Tracheobronchomalacia* / epidemiology
  • Tracheobronchomalacia* / physiopathology
  • United States / epidemiology