Respiratory disease and the oesophagus: Reflux, reflexes and microaspiration

Lesley A. Houghton, Augustine S. Lee, Huda Badri, Kenneth R. Devault, Jaclyn A. Smith

Research output: Contribution to journalReview article

27 Citations (Scopus)

Abstract

Gastro-oesophageal reflux is associated with a wide range of respiratory disorders, including asthma, isolated chronic cough, idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease and cystic fibrosis. Reflux can be substantial and reach the proximal margins of the oesophagus in some individuals with specific pulmonary diseases, suggesting that this association is more than a coincidence. Proximal oesophageal reflux in particular has led to concern that microaspiration might have an important, possibly even causal, role in respiratory disease. Interestingly, reflux is not always accompanied by typical reflux symptoms, such as heartburn and/or regurgitation, leading many clinicians to empirically treat for possible gastro-oesophageal reflux. Indeed, costs associated with use of acid suppressants in pulmonary disease far outweigh those in typical GERD, despite little evidence of therapeutic benefit in clinical trials. This Review comprehensively examines the possible mechanisms that might link pulmonary disease and oesophageal reflux, highlighting the gaps in current knowledge and limitations of previous research, and helping to shed light on the frequent failure of antireflux treatments in pulmonary disease.

Original languageEnglish (US)
Pages (from-to)445-460
Number of pages16
JournalNature Reviews Gastroenterology and Hepatology
Volume13
Issue number8
DOIs
StatePublished - Aug 1 2016

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Gastroesophageal Reflux
Esophagus
Reflex
Lung Diseases
Heartburn
Idiopathic Pulmonary Fibrosis
Treatment Failure
Cough
Cystic Fibrosis
Chronic Obstructive Pulmonary Disease
Asthma
Clinical Trials
Costs and Cost Analysis
Acids
Research
Therapeutics

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Respiratory disease and the oesophagus : Reflux, reflexes and microaspiration. / Houghton, Lesley A.; Lee, Augustine S.; Badri, Huda; Devault, Kenneth R.; Smith, Jaclyn A.

In: Nature Reviews Gastroenterology and Hepatology, Vol. 13, No. 8, 01.08.2016, p. 445-460.

Research output: Contribution to journalReview article

Houghton, Lesley A. ; Lee, Augustine S. ; Badri, Huda ; Devault, Kenneth R. ; Smith, Jaclyn A. / Respiratory disease and the oesophagus : Reflux, reflexes and microaspiration. In: Nature Reviews Gastroenterology and Hepatology. 2016 ; Vol. 13, No. 8. pp. 445-460.
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