Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2013

Open Access 01-12-2013 | Case report

Gastroesophageal reflux in Bronchiectasis and the effect of anti-reflux treatment

Authors: Zhi-Wei Hu, Zhong-Gao Wang, Yu Zhang, Ji-Min Wu, Jian-Jun Liu, Fang-Fang Lu, Guang-Chang Zhu, Wei-Tao Liang

Published in: BMC Pulmonary Medicine | Issue 1/2013

Login to get access

Abstract

Background

Bronchiectasis is a progressive and fatal disease despite the available treatment regimens. Gastroesophageal reflux (GER) may play an important role in the progression of bronchiectasis. However, active anti-reflux intervention such as Stretta radiofrequency (SRF) and/or laparoscopic fundoplication (LF) have rarely been used to treat Bronchiectasis.

Case Presentation

Seven patients’ clinical outcomes for treating GER-related deteriorated bronchiectasis were retrospective reviewed. All patients were treated by SRF and/or LF, and had follow-up periods ranging from one to five years. Typical GER symptoms, respiratory symptoms, medication consumption and general health status were assessed during the follow-ups. At the latest follow-up all patients were alive. The typical GER symptoms disappeared in five people and were significantly improved in the other two. Two had complete remissions of both respiratory symptoms and bronchiectasis exacerbations; four had significantly improved respiratory symptoms to mild/moderate degrees as well as reduced or zero bronchiectasis exacerbations, which allowed them to resume the physical and social functions; one’s respiratory symptoms and bronchiectasis exacerbations were not much improved, yet she was in stable condition and satisfied with the results.

Conclusions

Potentially, GER plays an important role in some patients with bronchiectasis, and active anti-reflux treatments can be beneficial. Future clinical studies are suggested to clarify GER’s role in bronchiectasis and to further determine whether anti-reflux interventions for GER can improve the outcomes of patients with bronchiectasis.
Appendix
Available only for authorised users
Literature
1.
go back to reference Tasker AD, Flower CD: Imaging the airways. Hemoptysis, bronchiectasis, and small airways disease. Clin Chest Med. 1999, 20: 761-773. 10.1016/S0272-5231(05)70254-9. viiiCrossRefPubMed Tasker AD, Flower CD: Imaging the airways. Hemoptysis, bronchiectasis, and small airways disease. Clin Chest Med. 1999, 20: 761-773. 10.1016/S0272-5231(05)70254-9. viiiCrossRefPubMed
2.
go back to reference Weycker D, Edelsberg J, Oster G, Tino G: Prevalence and economic burden of bronchiectasis. Clin Pulmon Med. 2005, 12: 205-209. 10.1097/01.cpm.0000171422.98696.ed.CrossRef Weycker D, Edelsberg J, Oster G, Tino G: Prevalence and economic burden of bronchiectasis. Clin Pulmon Med. 2005, 12: 205-209. 10.1097/01.cpm.0000171422.98696.ed.CrossRef
4.
go back to reference Sepper R, Konttinen YT, Kemppinen P, Sorsa T, Eklund KK: Mast cells in bronchiectasis. Ann Med. 1998, 30: 307-315. 10.3109/07853899809005860.CrossRefPubMed Sepper R, Konttinen YT, Kemppinen P, Sorsa T, Eklund KK: Mast cells in bronchiectasis. Ann Med. 1998, 30: 307-315. 10.3109/07853899809005860.CrossRefPubMed
5.
go back to reference King PT, Holdsworth SR, Freezer NJ, Villanueva E, Gallagher M, Holmes PW: Outcome in adult bronchiectasis. COPD. 2005, 2: 27-34. 10.1081/COPD-200050685.CrossRefPubMed King PT, Holdsworth SR, Freezer NJ, Villanueva E, Gallagher M, Holmes PW: Outcome in adult bronchiectasis. COPD. 2005, 2: 27-34. 10.1081/COPD-200050685.CrossRefPubMed
6.
go back to reference Alzeer AH, Masood M, Basha SJ, Shaik SA: Survival of bronchiectatic patients with respiratory failure in ICU. BMC Pulm Med. 2007, 7: 17-10.1186/1471-2466-7-17.CrossRefPubMedPubMedCentral Alzeer AH, Masood M, Basha SJ, Shaik SA: Survival of bronchiectatic patients with respiratory failure in ICU. BMC Pulm Med. 2007, 7: 17-10.1186/1471-2466-7-17.CrossRefPubMedPubMedCentral
7.
go back to reference Keistinen T, Saynajakangas O, Tuuponen T, Kivela SL: Bronchiectasis: an orphan disease with a poorly-understood prognosis. Eur Respir J. 1997, 10: 2784-2787. 10.1183/09031936.97.10122784.CrossRefPubMed Keistinen T, Saynajakangas O, Tuuponen T, Kivela SL: Bronchiectasis: an orphan disease with a poorly-understood prognosis. Eur Respir J. 1997, 10: 2784-2787. 10.1183/09031936.97.10122784.CrossRefPubMed
8.
go back to reference ten Hacken NH, Wijkstra PJ, Kerstjens HA: Treatment of bronchiectasis in adults. BMJ. 2007, 335: 1089-1093. 10.1136/bmj.39384.657118.80.CrossRefPubMed ten Hacken NH, Wijkstra PJ, Kerstjens HA: Treatment of bronchiectasis in adults. BMJ. 2007, 335: 1089-1093. 10.1136/bmj.39384.657118.80.CrossRefPubMed
9.
go back to reference Sweet MP, Patti MG, Hoopes C, Hays SR, Golden JA: Gastro-oesophageal reflux and aspiration in patients with advanced lung disease. Thorax. 2009, 64: 167-173. 10.1136/thx.2007.082719.CrossRefPubMed Sweet MP, Patti MG, Hoopes C, Hays SR, Golden JA: Gastro-oesophageal reflux and aspiration in patients with advanced lung disease. Thorax. 2009, 64: 167-173. 10.1136/thx.2007.082719.CrossRefPubMed
10.
go back to reference Wang Z, Kotwal RM: Is GERD-induced asthma a different disease entity?. Ther Adv Respir Dis. 2012, 6: 57-10.1177/1753465811426446.CrossRefPubMed Wang Z, Kotwal RM: Is GERD-induced asthma a different disease entity?. Ther Adv Respir Dis. 2012, 6: 57-10.1177/1753465811426446.CrossRefPubMed
11.
go back to reference Wang ZG: It is gastroesophageal reflux disease, not asthma: a case report. Chin Med Sci J. 2006, 21: 189-193.PubMed Wang ZG: It is gastroesophageal reflux disease, not asthma: a case report. Chin Med Sci J. 2006, 21: 189-193.PubMed
12.
go back to reference Wang ZG, Wu JM, Liu JJ, Wang LY, Lai YG, Ibrahim IM, Wang XJ, Dardik H: Respiratory distress resulting from gastroesophageal reflux is not asthma, but laryngotracheal irritation, spasm, even suffocation. Chin Med Sci J. 2009, 24: 130-132. 10.1016/S1001-9294(09)60076-6.CrossRefPubMed Wang ZG, Wu JM, Liu JJ, Wang LY, Lai YG, Ibrahim IM, Wang XJ, Dardik H: Respiratory distress resulting from gastroesophageal reflux is not asthma, but laryngotracheal irritation, spasm, even suffocation. Chin Med Sci J. 2009, 24: 130-132. 10.1016/S1001-9294(09)60076-6.CrossRefPubMed
13.
go back to reference Johnson LF, DeMeester TR: Development of the 24-hour intraesophageal pH monitoring composite scoring system. J Clin Gastroenterol. 1986, 8 (Suppl 1): 52-58.CrossRefPubMed Johnson LF, DeMeester TR: Development of the 24-hour intraesophageal pH monitoring composite scoring system. J Clin Gastroenterol. 1986, 8 (Suppl 1): 52-58.CrossRefPubMed
14.
go back to reference Wang ZG, Wu JM, Liu JJ, Chen X, Wang LY, Gong Y, Hu YH: Stretta frequency for the treatment of GERD with the respiratory problem mainly: experience of 180 patients. J Gastroen Hepatol. 2007, 22: A139-A139. Wang ZG, Wu JM, Liu JJ, Chen X, Wang LY, Gong Y, Hu YH: Stretta frequency for the treatment of GERD with the respiratory problem mainly: experience of 180 patients. J Gastroen Hepatol. 2007, 22: A139-A139.
15.
go back to reference Wang ZG, Ji F, Wu JM, Lai YG, Gao X, Zhang CC: Effect of laparoscopic fundoplication treatment on gastroesophageal reflux disease -related respiratory symptoms. Front Med China. 2010, 4: 254-258. 10.1007/s11684-010-0029-2.CrossRef Wang ZG, Ji F, Wu JM, Lai YG, Gao X, Zhang CC: Effect of laparoscopic fundoplication treatment on gastroesophageal reflux disease -related respiratory symptoms. Front Med China. 2010, 4: 254-258. 10.1007/s11684-010-0029-2.CrossRef
16.
go back to reference Chang AB, Bilton D: Exacerbations in cystic fibrosis: 4–Non-cystic fibrosis bronchiectasis. Thorax. 2008, 63: 269-276. 10.1136/thx.2006.060913.CrossRefPubMed Chang AB, Bilton D: Exacerbations in cystic fibrosis: 4–Non-cystic fibrosis bronchiectasis. Thorax. 2008, 63: 269-276. 10.1136/thx.2006.060913.CrossRefPubMed
17.
go back to reference Tsang KW, Lam WK, Kwok E, Chan KN, Hu WH, Ooi GC, Zheng L, Wong BC, Lam SK: Helicobacter pylori and upper gastrointestinal symptoms in bronchiectasis. Eur Respir J. 1999, 14: 1345-1350. 10.1183/09031936.99.14613459.CrossRefPubMed Tsang KW, Lam WK, Kwok E, Chan KN, Hu WH, Ooi GC, Zheng L, Wong BC, Lam SK: Helicobacter pylori and upper gastrointestinal symptoms in bronchiectasis. Eur Respir J. 1999, 14: 1345-1350. 10.1183/09031936.99.14613459.CrossRefPubMed
18.
go back to reference Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R: The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006, 101: 1900-1920. 10.1111/j.1572-0241.2006.00630.x. quiz 1943CrossRefPubMed Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R: The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006, 101: 1900-1920. 10.1111/j.1572-0241.2006.00630.x. quiz 1943CrossRefPubMed
20.
go back to reference Henderson RD, Woolfe CR: Aspiration and gastroesophageal reflux. Can J Surg. 1978, 21: 352-354.PubMed Henderson RD, Woolfe CR: Aspiration and gastroesophageal reflux. Can J Surg. 1978, 21: 352-354.PubMed
21.
go back to reference Fortunato GA, Machado MM, Andrade CF, Felicetti JC, Camargo J, de J, Cardoso PF: Prevalence of gastroesophageal reflux in lung transplant candidates with advanced lung disease. J Bras Pneumol. 2008, 34: 772-778. 10.1590/S1806-37132008001000004.CrossRefPubMed Fortunato GA, Machado MM, Andrade CF, Felicetti JC, Camargo J, de J, Cardoso PF: Prevalence of gastroesophageal reflux in lung transplant candidates with advanced lung disease. J Bras Pneumol. 2008, 34: 772-778. 10.1590/S1806-37132008001000004.CrossRefPubMed
22.
go back to reference Canning BJ, Mazzone SB: Reflex mechanisms in gastroesophageal reflux disease and asthma. Am J Med. 2003, 115: 45s-48s. 10.1016/S0002-9343(03)00192-X.CrossRefPubMed Canning BJ, Mazzone SB: Reflex mechanisms in gastroesophageal reflux disease and asthma. Am J Med. 2003, 115: 45s-48s. 10.1016/S0002-9343(03)00192-X.CrossRefPubMed
23.
go back to reference Tsang KW, Tipoe GL: Bronchiectasis: not an orphan disease in the East. Int J Tuberc Lung Dis. 2004, 8: 691-702.PubMed Tsang KW, Tipoe GL: Bronchiectasis: not an orphan disease in the East. Int J Tuberc Lung Dis. 2004, 8: 691-702.PubMed
24.
go back to reference Mittal RK, Balaban DH: The esophagogastric junction. N Engl J Med. 1997, 336: 924-932. 10.1056/NEJM199703273361306.CrossRefPubMed Mittal RK, Balaban DH: The esophagogastric junction. N Engl J Med. 1997, 336: 924-932. 10.1056/NEJM199703273361306.CrossRefPubMed
25.
go back to reference Melvin WS: Modern treatment for gastroesophageal reflux disease: surgery vs medication. Arch Surg. 2011, 146: 1093-1094. 10.1001/archsurg.2011.202.CrossRefPubMed Melvin WS: Modern treatment for gastroesophageal reflux disease: surgery vs medication. Arch Surg. 2011, 146: 1093-1094. 10.1001/archsurg.2011.202.CrossRefPubMed
26.
go back to reference McCallister JW, Parsons JP, Mastronarde JG: The relationship between gastroesophageal reflux and asthma: an update. Ther Adv Respir Dis. 2011, 5: 143-150. 10.1177/1753465810384606.CrossRefPubMed McCallister JW, Parsons JP, Mastronarde JG: The relationship between gastroesophageal reflux and asthma: an update. Ther Adv Respir Dis. 2011, 5: 143-150. 10.1177/1753465810384606.CrossRefPubMed
27.
go back to reference Piterman L, Nelson M, Dent J: Gastro-oesophageal reflux disease–current concepts in management. Aust Fam Physician. 2004, 33: 987-991.PubMed Piterman L, Nelson M, Dent J: Gastro-oesophageal reflux disease–current concepts in management. Aust Fam Physician. 2004, 33: 987-991.PubMed
28.
go back to reference Galmiche JP, Zerbib F, Bruley des Varannes S: Review article: respiratory manifestations of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2008, 27: 449-464. 10.1111/j.1365-2036.2008.03611.x.CrossRefPubMed Galmiche JP, Zerbib F, Bruley des Varannes S: Review article: respiratory manifestations of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2008, 27: 449-464. 10.1111/j.1365-2036.2008.03611.x.CrossRefPubMed
29.
go back to reference Gao X, Wang ZG, Wu JM, Ji F, Zhang CC, Ning YC, Li ZT, Hu ZW, Chen X, Tian SR: Radiofrequency treatment on respiratory symptoms due to gastroesophageal reflux disease. Chin Med J (Engl). 2011, 124: 1006-1009. Gao X, Wang ZG, Wu JM, Ji F, Zhang CC, Ning YC, Li ZT, Hu ZW, Chen X, Tian SR: Radiofrequency treatment on respiratory symptoms due to gastroesophageal reflux disease. Chin Med J (Engl). 2011, 124: 1006-1009.
30.
go back to reference Wen BL, Liu BY, Jin P, Wang XF, Xiang XX, Liu XF, Hu JQ, Lu F, He LY, Zhu WZ, et al: Clinical research of acupoint application for “treatment of winter disease in summer” used to prevent and treat bronchial asthma in children. J Tradit Chin Med. 2012, 32: 31-39. 10.1016/S0254-6272(12)60028-4.CrossRefPubMed Wen BL, Liu BY, Jin P, Wang XF, Xiang XX, Liu XF, Hu JQ, Lu F, He LY, Zhu WZ, et al: Clinical research of acupoint application for “treatment of winter disease in summer” used to prevent and treat bronchial asthma in children. J Tradit Chin Med. 2012, 32: 31-39. 10.1016/S0254-6272(12)60028-4.CrossRefPubMed
31.
go back to reference Hu ZW, Wang ZG, Wu JM, Tan ST: Anti-reflux procedure for difficult-to-treat asthmatic children, case report and literature review. Multidiscip Respir Med. 2012, 7: 28-10.1186/2049-6958-7-28.CrossRefPubMedPubMedCentral Hu ZW, Wang ZG, Wu JM, Tan ST: Anti-reflux procedure for difficult-to-treat asthmatic children, case report and literature review. Multidiscip Respir Med. 2012, 7: 28-10.1186/2049-6958-7-28.CrossRefPubMedPubMedCentral
32.
go back to reference Linden PA, Gilbert RJ, Yeap BY, Boyle K, Deykin A, Jaklitsch MT, Sugarbaker DJ, Bueno R: Laparoscopic fundoplication in patients with end-stage lung disease awaiting transplantation. J Thorac Cardiovasc Surg. 2006, 131: 438-446. 10.1016/j.jtcvs.2005.10.014.CrossRefPubMed Linden PA, Gilbert RJ, Yeap BY, Boyle K, Deykin A, Jaklitsch MT, Sugarbaker DJ, Bueno R: Laparoscopic fundoplication in patients with end-stage lung disease awaiting transplantation. J Thorac Cardiovasc Surg. 2006, 131: 438-446. 10.1016/j.jtcvs.2005.10.014.CrossRefPubMed
33.
go back to reference Gasper WJ, Sweet MP, Hoopes C, Leard LE, Kleinhenz ME, Hays SR, Golden JA, Patti MG: Antireflux surgery for patients with end-stage lung disease before and after lung transplantation. Surg Endosc. 2008, 22: 495-500. 10.1007/s00464-007-9494-3.CrossRefPubMed Gasper WJ, Sweet MP, Hoopes C, Leard LE, Kleinhenz ME, Hays SR, Golden JA, Patti MG: Antireflux surgery for patients with end-stage lung disease before and after lung transplantation. Surg Endosc. 2008, 22: 495-500. 10.1007/s00464-007-9494-3.CrossRefPubMed
34.
go back to reference Hoppo T, Jarido V, Pennathur A, Morrell M, Crespo M, Shigemura N, Bermudez C, Hunter JG, Toyoda Y, Pilewski J, et al: Antireflux surgery preserves lung function in patients with gastroesophageal reflux disease and end-stage lung disease before and after lung transplantation. Arch Surg. 2011, 146: 1041-1047. 10.1001/archsurg.2011.216.CrossRefPubMed Hoppo T, Jarido V, Pennathur A, Morrell M, Crespo M, Shigemura N, Bermudez C, Hunter JG, Toyoda Y, Pilewski J, et al: Antireflux surgery preserves lung function in patients with gastroesophageal reflux disease and end-stage lung disease before and after lung transplantation. Arch Surg. 2011, 146: 1041-1047. 10.1001/archsurg.2011.216.CrossRefPubMed
35.
go back to reference Robertson AG, Krishnan A, Ward C, Pearson JP, Small T, Corris PA, Dark JH, Karat D, Shenfine J, Griffin SM: Anti-reflux surgery in lung transplant recipients: outcomes and effects on quality of life. Eur Respir J. 2012, 39: 691-697. 10.1183/09031936.00061811.CrossRefPubMed Robertson AG, Krishnan A, Ward C, Pearson JP, Small T, Corris PA, Dark JH, Karat D, Shenfine J, Griffin SM: Anti-reflux surgery in lung transplant recipients: outcomes and effects on quality of life. Eur Respir J. 2012, 39: 691-697. 10.1183/09031936.00061811.CrossRefPubMed
36.
go back to reference Davis RD, Lau CL, Eubanks S, Messier RH, Hadjiliadis D, Steele MP, Palmer SM: Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation. J Thorac Cardiovasc Surg. 2003, 125: 533-542. 10.1067/mtc.2003.166.CrossRefPubMed Davis RD, Lau CL, Eubanks S, Messier RH, Hadjiliadis D, Steele MP, Palmer SM: Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation. J Thorac Cardiovasc Surg. 2003, 125: 533-542. 10.1067/mtc.2003.166.CrossRefPubMed
37.
go back to reference Saynajakangas O, Keistinen T, Tuuponen T, Kivela SL: Links between hospital diagnoses of bronchiectasis and asthma. Allergy. 1997, 52: 1120-1122. 10.1111/j.1398-9995.1997.tb00186.x.CrossRefPubMed Saynajakangas O, Keistinen T, Tuuponen T, Kivela SL: Links between hospital diagnoses of bronchiectasis and asthma. Allergy. 1997, 52: 1120-1122. 10.1111/j.1398-9995.1997.tb00186.x.CrossRefPubMed
38.
go back to reference Oguzulgen IK, Kervan F, Ozis T, Turktas H: The impact of bronchiectasis in clinical presentation of asthma. South Med J. 2007, 100: 468-471. 10.1097/SMJ.0b013e31802fa16f.CrossRefPubMed Oguzulgen IK, Kervan F, Ozis T, Turktas H: The impact of bronchiectasis in clinical presentation of asthma. South Med J. 2007, 100: 468-471. 10.1097/SMJ.0b013e31802fa16f.CrossRefPubMed
39.
go back to reference Hatlebakk JG: Endoscopy in gastro-oesophageal reflux disease. Best Pract Res Clin Gastroenterol. 2010, 24: 775-786. 10.1016/j.bpg.2010.09.005.CrossRefPubMed Hatlebakk JG: Endoscopy in gastro-oesophageal reflux disease. Best Pract Res Clin Gastroenterol. 2010, 24: 775-786. 10.1016/j.bpg.2010.09.005.CrossRefPubMed
40.
go back to reference Tutuian R, Castell DO: Review article: complete gastro-oesophageal reflux monitoring - combined pH and impedance. Aliment Pharmacol Ther. 2006, 24 (Suppl 2): 27-37.CrossRefPubMed Tutuian R, Castell DO: Review article: complete gastro-oesophageal reflux monitoring - combined pH and impedance. Aliment Pharmacol Ther. 2006, 24 (Suppl 2): 27-37.CrossRefPubMed
41.
go back to reference Akyuz F, Arici S, Ermis F, Mungan Z: Utility of esophageal manometry and pH-metry in gastroesophageal reflux disease before surgery. Turk J Gastroenterol. 2009, 20: 261-265.CrossRefPubMed Akyuz F, Arici S, Ermis F, Mungan Z: Utility of esophageal manometry and pH-metry in gastroesophageal reflux disease before surgery. Turk J Gastroenterol. 2009, 20: 261-265.CrossRefPubMed
42.
go back to reference Reichel O, Issing WJ: Impact of different pH thresholds for 24-hour dual probe pH monitoring in patients with suspected laryngopharyngeal reflux. J Laryngol Otol. 2008, 122: 485-489.CrossRefPubMed Reichel O, Issing WJ: Impact of different pH thresholds for 24-hour dual probe pH monitoring in patients with suspected laryngopharyngeal reflux. J Laryngol Otol. 2008, 122: 485-489.CrossRefPubMed
Metadata
Title
Gastroesophageal reflux in Bronchiectasis and the effect of anti-reflux treatment
Authors
Zhi-Wei Hu
Zhong-Gao Wang
Yu Zhang
Ji-Min Wu
Jian-Jun Liu
Fang-Fang Lu
Guang-Chang Zhu
Wei-Tao Liang
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2013
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/1471-2466-13-34

Other articles of this Issue 1/2013

BMC Pulmonary Medicine 1/2013 Go to the issue