Pulmonary Diseases

This page is presently in a totally raw state.

These are relevant chronological links from the Barrett's Wessex 2012-2020 research archive that will need commenting on and context later.

We welcome comments via support@Barretts.org.uk. Please use reference letter for any research you wish to refer to.

A) 18 September 2013 GERD prevalence raised even in mild–moderate COPD, bronchiectasis "researchers found evidence for pulmonary aspiration of gastric contents" (Respirology)

B) 18 October 2013 Association Between Chronic Obstructive Pulmonary Disease and Gastroesophageal Reflux Disease "The presence of GERD was associated with COPD exacerbation." (BMC Pulmonary medicine)

C) 1 May 2014 Effect of Esomeprazole Versus Placebo on Pulmonary Exacerbations in Cystic Fibrosis "Asymptomatic gastroesophageal reflux is present in the majority of patients with cystic fibrosis. Risk and benefits of acid suppressive agents in cystic fibrosis require further study." (BMC Pulmonary medicine)

D) 31 October 2014 Newly diagnosed gastroesophageal reflux disease increased the risk of Acute Exacerbation of Chronic Obstructive Pulmonary Disease during the first year following diagnosis - a nationwide population-based cohort study. "This study demonstrated that GERD is an independent risk factor for AECOPD. Caution should be exercised when assessing GERDsymptoms in patients with COPD." (International Journal of Clinical Practice)

E) 7 November 2014 Gastroesophageal reflux as a cause of chronic cough, severe asthma, and migratory pulmonary infiltrates. "Respiratory symptoms improved notably after abdominal surgery to correct the GER, suggesting a close causal relationship between GER and all the symptoms, including asthma. However, this issue remains unresolved in the literature." (Respirology case reports)

F) 12 January 2015 Solitary Lung Masses due to Occult Aspiration. "Aspiration-related pulmonary complications can present as a solitary lung mass which may not be located in dependent lung zones that have traditionally been associated with aspiration-related pulmonary diseases." (American Journal of Medicine)

G) 10 February 2015 Gastroesophageal reflux disease and non-digestive tract diseases. "This review considers and emphasizes the association between GERD and non-digestive tract conditions, including atrial fibrillation, chronic obstructive pulmonary disease, primary pulmonary fibrosis and energy metabolism related to diet." (Expert review of Gastroenterology and Hepatology)

H) March 2015 Aspiration-related pulmonary syndromes. "Aspiration of foreign matter into the airways and lungs can cause a wide spectrum of pulmonary disorders with various presentations." (Chest)

I) 8 April 2015 Experimental pulmonary fibrosis in rats with chronic gastric acid reflux esophagitis "These results suggest that gastric acid reflux may be one of the pathogenic or exacerbating factors of pulmonary fibrosis." (Auris, Nasus, Larynx)

J) 9 May 2015 Airway-centered interstitial fibrosis: etiology, clinical findings and prognosis. "ACIF is an interstitial lung disease with a better survival when compared with IPF [Interstitial Pulmonary fibrosis]. The main etiologies are HP [Hypersensitivity Pneumonitis] and GERD." (Respiratory Reseacrh)

K) 23 June 2015 Gastroesophageal reflux and lung disease. "Recent data suggest that antireflux surgery may be more effective in preventing lung disease progression in patients with idiopathic pulmonary fibrosis" (Expert Review Respiratory Medicine)

L) 14 July 2015 Idiopathic pulmonary fibrosis is associated with increased impedance measures of reflux compared to non-fibrotic disease among prelung transplant patients. "Abnormal reflux was significantly more prevalent among IPF patients after controlling for lung disease severity.Gastroesophageal reflux/microaspiration likely plays a role in fibrosis in IPF. A significant portion of IPF patients had increased non-acid reflux. Therapies aiming to prevent reflux of gastric contents may be more beneficial than antisecretory medications alone in these patients." (Neurogastroenterolgy & Motility)

M) 15 July 2015 Clinical significance of laryngopharyngeal reflux in patients with chronic obstructive pulmonary disease. "Laryngeal examination and evaluation of laryngeal reflux symptom could be a surrogate clinical indicator related to severe acute exacerbation of COPD" (International Journal of Chronic Obstructive Pulmonary Disease)

N) July 2015 Associations between gastro-oesophageal reflux, its management and exacerbations of chronic obstructive pulmonary disease. "GORD in COPD patients is highly prevalent, and risk factors did not differ by sex. Use of PPI/H2RA and self-reported GORD were associated with increased risk of moderate-to-severe and hospitalised exacerbations." (Respiratory Medicine)

O) 25 April 2016 Idiopathic Pulmonary Fibrosis: Novel Concepts of Proton Pump Inhibitors as Antifibrotic Drug. "Findings of abnormal reflux persists in large proportion of IPF patients placed on antiacid therapy such as proton pump inhibitors (PPIs). This seemingly paradoxical observation suggests that either IPF patients are somehow resistant to PPI-based intervention or PPIs are inherently unable to suppress acid GER. By contrast, IPF patients who undergo Nissen fundoplication surgery are effectively relieved from the complications of GER and retrospective studies suggest improved lung function" (American Journal Respiratory & Critical Care Medicine)

P) 17 May 2016 Bile acids induce activation of alveolar epithelial cells and lung fibroblasts through farnesoid X receptor-dependent and independent pathways. "Bile acid microaspiration may promote the development of pulmonary fibrosis by inducing activation of AECs and lung fibroblasts via FXR-dependent and independent pathways." (Respirology)

Q) 25 July 2016 Effect of Proton Pump Inhibitors in Bronchiectatic Patients with Gastroesophageal Reflux Disease. "PPIs have no effect on the pulmonary function in patients with bronchiectasis and GERD. However, PPIs were noted to produce improvements in lung function in patients with bronchiectasis and high BMI." (Korean Journal of Gastroenterology)

R) 16 December 2016 Lung disease severity in idiopathic pulmonary fibrosis is more strongly associated with impedance measures of bolus reflux than pH parameters of acid reflux alone. "bolus reflux, but not pH/acid reflux, was associated with pulmonary dysfunction in prelung transplant patients with IPF" (Neurogastroenterology & Motility)

S) 3 March 2017 Gastroesophageal Reflux and Idiopathic Pulmonary Fibrosis. "A phase II NIH study is currently in progress in the USA to determine the role of antireflux surgery in patients with GERD and IPF. The hope is that this simple operations might alter the natural history of IPF, avoiding progression and the need for lung transplantation." (World Journal of Surgery)

T) 24 March 2017 Chronic microaspiration of bile acids induces lung fibrosis through multiple mechanisms in rats. "Our findings suggest that microaspiration of bile acids could promote the development of pulmonary fibrosis in vivo" (Clinical Science)

U) 4 June 2017 Gastroesophageal Reflux and Idiopathic Pulmonary Fibrosis. "Medical therapy with acid-reducing medications controls the production of acid and has some benefit. However, reflux and aspiraion of weakly acidic or alkaline gastric contents can still occur. Better results have been reported after laparoscopic anti-reflux surgery, as this form of therapy re-establishes the competence of the lower esophageal sphincter, therefore stopping any type of reflux." (World Jouranl of Surgery)

V) September 2017 Gastroesophageal reflux disease: An important consideration for respiratory disorders. "GERD has been associated with a wide range of respiratory disorders, including asthma, chronic cough, and idiopathic pulmonary fibrosis (IPF) [1], as well as chronic obstructive pulmonary disease (COPD) and cystic fibrosis [3]." (Respiratory Investgation)

W) November [GASTROESOPHAGEAL REFLUX DISEASE – A MULTIFACETED DISEASE]. "Extraesophageal reflux disease represents a wide range of symptoms connected to the upper and lower respiratory system, such as cough, laryngitis, asthma, chronic obstructive pulmonary disease, hoarseness, sinusitis-postnasal drip syndrome, otitis media, recurrent pneumonia and laryngeal carcinoma." (Acta Medica Croatia)

X) October 2017 Proton Pump Inhibitor Use Is Associated With an Increased Frequency of Hospitalization in Patients With Cystic Fibrosis."PPI use is highly prevalent in CF patients. Exposure to PPI therapy is independently associated with a higher number of hospitalizations for pulmonary exacerbation in CF patients." (Gastroenterology Research)

Y) 29 November 2017 Review article: gastro-oesophageal reflux disease in asthma and chronic obstructive pulmonary disease. "Estimates for the prevalence of GERD in asthma range from 30% to 90%, compared to an average of 24% in controls. In COPD patients, the prevalence of GERD ranges from 19% to 78% compared to an average of 18% in controls. These data indicate an increased prevalence of GERD in patients with asthma and COPD, although causality is not established and GERD treatment yielded inconsistent effects." (Alimentary Pharmacology & therapeutics)

Z) January 2018 Chronic Obstructive Pulmonary Disease Exacerbations Are Influenced by Gastroesophageal Reflux Disease. "We believe GERD must be objectively tested in patients with COPD because the prevalence of GERD in these patients is underestimated when only symptoms are considered. GERD treatment might decrease the frequency of episodes of exacerbation." (American Surgeon)

AA) January - March 2018 Gastro Oesophageal Reflux Diseases In Chronic Obstructive Pulmonary Disease Patients. "Our study shows that a higher proportion of gastro oesophageal reflux (GERD) symptoms are present in COPD patients and it also shows that GERD is more common in severe COPD patients." (Journal of Ayub Medical College)

AB) May 2018 Gastroesophageal reflux symptoms and nasal symptoms affect the severity of bronchitis symptoms in patients with chronic obstructive pulmonary disease. "This study showed that the presence of GERD and/or nasal symptoms is associated with an increase in bronchitis symptoms. Careful assessment of extrapulmonary comorbidities is necessary in the evaluation of bronchitis symptoms in COPD patients." (Respiratory Investigation)

AC) June 2018 Assessment of anti-reflux treatment on pulmonary ventilation function and inflammatory cytokines in patients with stable chronic obstructive pulmonary disease combined with gastroesophageal reflux. "The key findings of the study suggested that conventional treatment combined with anti-reflux treatment could effectively improve pulmonary ventilation function, while acting to decrease the levels of inflammatory cytokines and improve the prognosis of patients with stable COPD along with GER." (Experimental & Therapeutic Medicine)

AD) 9 August 2018 Laparoscopicanti-reflux surgery for the treatment of idiopathic pulmonaryfibrosis (WRAP-IPF): a multicentre, randomised, controlled phase 2trial (full text) "the results of this trial show that laparoscopic anti-reflux surgery in patients with IPF and abnormal acid GER is safe and well tolerated" (Lancet)

AE) 15 August 2018 Meta-Analysis of Gastroesophageal Reflux Disease and Idiopathic Pulmonary Fibrosis."GERD and IPF may be related but this association is most likely confounded, especially by smoking" (Chest)

AF) 19 September 2018 Proton pump inhibitors use is associated with a lower risk of acute exacerbation and mortality in patients with coexistent COPD and GERD. (full text) "Use of proton pump inhibitors was associated with a lower risk of acute exacerbation and mortality in the patients with COPD and symptomatic GERD." (Internal Journal of Chronic Obstructive Pulmonary Disease)

AG) 27 September 2018 Use of Online Symptom Checkers to Delineate the Ever-Elusive GERD versus Non-GERD Cough. "Pulmonary manifestations, such as cough, have been recognized as a potential consequence of GERD, with the prevalence of GERD-associated cough ranging from 10%-40%" (Clinical Respiratory Journal)

AH) 9 October 2018 Benchmarking of a Simple Scintigraphic Test for Gastro-oesophageal Reflux Disease That Assesses Oesophageal Disease and Its Pulmonary Complications (full text) "Scintigraphic reflux studies offer a viable alternative test for GORD and extra-oesophageal manifestations of reflux disease. Strong correlations were found between measurable scintigraphic parameters and oesophageal motility and lung aspiration of refluxate. This may provide a more confident decision analysis in patients being considered for fundoplication for troubling extra-oesophageal symptoms." (Molecular imaging and radionuclide therapy)

AI) 11 October 2018 Gastroesophageal Reflux Disease in Idiopathic Pulmonary Fibrosis: Uncertainties and Controversies. "On the basis of the possible beneficial effects of antireflux or antacid therapy on lung function, acute exacerbation, and survival, the recent international IPF guideline recommends antacid therapies for patients with IPF, regardless of symptomatic GERD. However, due to newer conflicting data, several national guidelines do not support this recommendation." (Respiration)

AJ) 4 January 2019 Randomised, double-blind, placebo-controlled pilot trial of omeprazole in idiopathic pulmonary fibrosis. (full text) "Our data suggested that, on average, cough was reduced in the omeprazole group, although this was not statistically significant" (Thorax)

AK) 17 April 2019 Chronic Obstructive Pulmonary Disease and the Risk of Esophagitis, Barrett Esophagus, and Esophageal Adenocarcinoma: A Primary Care Case-Control Study "COPD is associated with an increased risk of reflux esophagitis and Barrett esophagus but not EAC." (Journal of Clinical Gastroenterology)

AL) 3 May 2019 Gastroesophageal reflux and antacid therapy in IPF: analysis from the Australia IPF Registry (full text) "Neither the use of antacid therapy nor the presence of GORD symptoms affects longer term outcomes in IPF patients. This contributes to the increasing evidence that antacid therapy may not be beneficial in IPF patients and that GORD directed therapy should be considered on an individual basis to treat the symptoms of reflux." (BMC Pulmonary Medicine)

AM) 23 October 2019 Journal Club-- COPD Exacerbations and Gastroesophageal Reflux Disease: Why Proton Pump Inhibitor Therapy is Not Enough (full text) "GERD in COPD patients has been associated with the COPD/bronchiectasis overlap ... The extent and mechanisms by which aspiration may contribute to frequent exacerbations remains poorly understood and is likely complex including factors that increase the risk of aspiration and factors that increase susceptibility including structural changes and alterations in local immunity. In this Journal Club we will review some of the more recent literature published regarding these issues." (Chronic Obstructive Pulmonary Diseases)

AN) 8 January 2020 A systematic review with meta-analysis of gastroesophageal reflux disease and exacerbations of chronic obstructive pulmonary disease (full text) "A total of 13,245 patients from 10 observational articles were included in the meta-analysis. The meta-analysis indicated that GERD is associated with increased risk of COPD exacerbation (OR: 5.37; 95% CI 2.71-10.64). Patients with COPD and GERD had increased number of exacerbation (WMD: 0.48; 95% CI: 0.31 to 0.65)." (BMC Pulmonary Medicine)

AO) 18 April 2020 Pulmonary manifestations of gastroesophageal reflux disease "GERD is often overlooked as a cause of respiratory symptoms and illnesses. The literature is sparse on the relation between GERD and respiratory diseases such as interstitial lung diseases and bronchiolitis obliterans including its role in pathogenesis, mechanisms of lung injury and whether treatment of GERD is effective in managing such illnesses." (Expert Review of Respiratory Medicine)

AP) 17 August 2020 Extraesophageal syndrome of gastroesophageal reflux: relationships with lung disease and transplantation outcome "Gastroesophageal reflux disease (GERD) is prevalent and may be associated with both esophageal and extraesophageal syndromes, which include various pulmonary conditions. GERD may lead to pulmonary complications through the "reflux" (aspiration) or "reflex" (refluxate-triggered, vagally mediated airway spasm) mechanisms." "Antireflux therapy may improve outcomes of some pulmonary complications of GERD, although careful selection of a candidate is paramount to successful outcomes." (Annals of New York Academy of Sciences)

AQ) 25 August 2020 Proton pump inhibitors for chronic obstructive pulmonary disease "pulmonary microaspiration of gastric acid is thought to be a possible cause of COPD exacerbations. Therefore, reducing gastric acid secretion may lead to a reduction in COPD exacerbations. Proton pump inhibitors (PPIs) are one of the most commonly prescribed medications and are recommended as first-line therapy for people with GERD because of their inhibitory effects on gastric acid secretion. Treatment with PPIs may present a viable treatment option for people with COPD." (Cochrane Database of Systematic Reviews)

AR) 31 August 2020 Effectiveness of proton pump inhibitors in idiopathic pulmonary fibrosis: a population-based cohort study "PPI use was not associated with lower mortality or hospitalization incidence in this large study conducted among patients with IPF within a real world setting of clinical practice and designed to avoid biases affecting previous studies. PPIs may not be as beneficial in treating IPF as suggested by some studies and conditionally recommended in treatment guidelines." (Chest)

AS) 25 February 2022 Gastroesophageal Reflux Disease and Idiopathic Lung Fibrosis. From Heartburn to Lung Transplant, and Beyond " In patients waiting for lung transplantation (if they can tolerate a laparoscopic operation under general anesthesia), a fundoplication before the operation might block the progression of IPF, while after transplantation it might prevent rejection by preventing the bronchiolitis obliterans syndrome." (American Surgeon)