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J R Soc Med. 1998 January; 91(1): 10–12.
PMCID: PMC1296416

Tracheal microaspiration in adult cystic fibrosis.


Gastro-oesophageal reflux (GOR) has been implicated in the aetiology of lung disease. Cystic fibrosis (CF) patients have a high incidence of GOR symptoms with demonstrable episodes of oesophageal acidification. We studied 24-hour ambulatory tracheal and oesophageal pH in 11 CF patients with GOR symptoms to identify any episodes of tracheal acidification and define their temporal relation to oesophageal reflux and respiratory symptoms. 8 patients had evidence of significant GOR (DeMeester score mean 58; range 17-107) and in 6 it was gross (DeMeester score > 30). 4 patients had tracheal acidification (defined as tracheal pH < 5.5): all had greatly raised DeMeester scores. Two patterns of lowered tracheal pH were seen: a gradual drift downwards of tracheal pH to < 5.5 which recovered slowly, and an acute fall in tracheal pH to < 5.5 with rapid recovery. Only one patient had a fall in peak expiratory flow in conjunction with a decline in tracheal pH, and no association was found between the presence of tracheal microaspiration and pulmonary function. We conclude that tracheal acidification occurs in adult CF patients with GOR.

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Selected References

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  • Orenstein SR, Orenstein DM. Gastroesophageal reflux and respiratory disease in children. J Pediatr. 1988 Jun;112(6):847–858. [PubMed]
  • Barish CF, Wu WC, Castell DO. Respiratory complications of gastroesophageal reflux. Arch Intern Med. 1985 Oct;145(10):1882–1888. [PubMed]
  • Nelson HS. Gastroesophageal reflux and pulmonary disease. J Allergy Clin Immunol. 1984 May;73(5 Pt 1):547–556. [PubMed]
  • Allen CJ, Newhouse MT. Gastroesophageal reflux and chronic respiratory disease. Am Rev Respir Dis. 1984 Apr;129(4):645–647. [PubMed]
  • Scott RB, O'Loughlin EV, Gall DG. Gastroesophageal reflux in patients with cystic fibrosis. J Pediatr. 1985 Feb;106(2):223–227. [PubMed]
  • Ledson MJ, Tran J, Walshaw MJ. Prevalence and mechanisms of gastro-oesophageal reflux in adult cystic fibrosis patients. J R Soc Med. 1998 Jan;91(1):7–9. [PMC free article] [PubMed]
  • Jack CI, Walshaw MJ, Tran J, Hind CR, Evans CC. Twenty-four-hour tracheal pH monitoring--a simple and non-hazardous investigation. Respir Med. 1994 Jul;88(6):441–444. [PubMed]
  • Goodall RJ, Earis JE, Cooper DN, Bernstein A, Temple JG. Relationship between asthma and gastro-oesophageal reflux. Thorax. 1981 Feb;36(2):116–121. [PMC free article] [PubMed]
  • Nagel RA, Brown P, Perks WH, Wilson RS, Kerr GD. Ambulatory pH monitoring of gastro-oesophageal reflux in "morning dipper" asthmatics. BMJ. 1988 Nov 26;297(6660):1371–1373. [PMC free article] [PubMed]
  • Harper PC, Bergner A, Kaye MD. Antireflux treatment for asthma. Improvement in patients with associated gastroesophageal reflux. Arch Intern Med. 1987 Jan;147(1):56–60. [PubMed]

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