Gastroesophageal Reflux and Aspiration in Chronic Lung Allograft Dysfunction and Bronchiolitis Obliterans Syndrome: Detection and Treatment

Chapter
Part of the Respiratory Medicine book series (RM, volume 8)

Abstract

The role of gastroesophageal reflux (GER) as a risk factor in chronic lung allograft dysfunction (CLAD) and/or bronchiolitis obliterans syndrome (BOS) is strongly supported by the cumulative evidence collected to date. Proximal gastrointestinal tract motility studies and pH/impedance testing can be used to diagnose motility abnormalities and GER and to determine whether reflux is acid or nonacid. However, a true gold standard methodology for detecting penetrance of refluxed duodeno-gastric secretions into the lung is lacking, and a definitive marker of GER combined with microaspiration that identifies patients at significant risk for associated allograft injury and dysfunction needs to be determined. Prospective, multicenter, adequately powered clinical trials should be performed to better understand the role of GER in CLAD and to identify appropriate criteria for patient selection for possible surgical correction of GER.

Keywords

Lung transplantation Gastroesophageal reflux Nonacid reflux Chronic lung allograft dysfunction Bronchiolitis obliterans syndrome 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of SurgeryNew York-Presbyterian Hospital, Columbia University Medical CentreNew YorkUSA
  2. 2.Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’AdultoAzienda Ospedaliero-Universitaria Policlinico di ModenaModenaItaly

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