A Study In The Correlation Between The Gastroesophageal Reflux Disease(GERD) And The Impairment Of The Pulmonary Function

Patients 33 patients diagnosed as GERD, including 19 males(age 30-72) and 14 females(age 23-67). We carried out the ambulatory 24-hour pH monitor and the lung function test on all the patients. Groups The patients were divided into two groups: group A(n=17) who have the positive pH monitor results(Demeester score≥14.7) and group B(n=16) whose pH monitor results were negative(Demeester score<14.7). Results Patients in group A have the abnormal V25% and V50%(percentage of actual value/predict value, %), which are the sensitive indexes of the small airway resistance. No abnormal function test result was shown in group B. Statistical analysis shows that some acid reflux indexes are correlated to the small airway resistance, including Demeester score, total reflux number and percentage time that pH below 4. 4 patients receiving anti-reflux treatment(omeprazole 20mg, bid, and cisapride 5mg, tid) re-examined after 2 weeks, including 2 patients who had the repeated respiratory symptoms such as cough and gasp. All 4 patients' lung function tests show the improvement changes, and the 2 patients' respiratory symptoms were improved. But it could not be statistically analyzed because of limited sample size.Conclusions In this experiment we found that vagus reflex plays the more important role in the pathogenesis of the lung function impairment in GERD patients. The main lung function impairment in GERD is the increment of the small airway resistance, which could be reflected by the most sensitive indexes V25% and V50%. And most of patients' respiratory symptoms are nocturnal. But there are still some patients' complaints happened in the day time and several patients had the nonbacterial chronic respiratory inflammations, which suggests the possible acid aspiration. There were no abnormal lung function test result in the base reflux or combining base reflux patients, which suggests that acid reflux be the main element in GERD patients. We found that several reflux indexes were correlated with the small airway resistance, particularly the Demeester score. There are 4 patients who have the most severe acid reflux show the obvious obstructive ventilation dysfunction. We conclude that the more severe acid reflux patients are likely to have more severe respiratory dysfunction. The lung function impairment in GERD is reversible, which could be achieved by the acid inhibition and so on.