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Lung function parameters in patients with gastroesophageal reflux without respiratory symptoms: a case-control study

Masoud Nazemiyeh, Masoud Nouri-Vaskeh, Mohammad Hossein Somi, Ehsan Saeedi, Akbar Sharifi




Aim: This research aimed to evaluate the effect of gastroesophageal reflux disease (GERD) on pulmonary volumes, airflows, and airway resistance in the patients without respiratory symptoms and compare them with the healthy subjects.

Background: GERD is the return of gastric content into the esophagus and beyond. GERD may play an essential role in the extraesophageal diseases, including chest pain, asthma, laryngitis, chronic cough, and sinusitis. The relation between GERD and airway involvement in asthma and also bronchoconstrictor effects of GERD are well recognized, but its impact on lung parameters in the patients with GERD without respiratory symptoms is unclear.

Methods: In a case-control study, 78 GERD patients without pulmonary symptoms and 93 healthy subjects as control group were enrolled. The impulse oscillometry examined airway resistance. The body plethysmograph measured the pulmonary volumes and airflows.

Results: The mean age of GERD patients and the healthy subjects were 37.30±9.76 and 34.74±11.10, respectively. A total of 53.8% of patients and 67.7% of healthy subjects were male. The lung volumes measured by the body plethysmography were normal in both patients and healthy subjects. However, there was a significant difference between the groups in forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) (P=0.01) and maximal mid expiratory flow (MMEF) (P=0.008). Airway resistance at R5Hz was significantly higher in the case group than the control group (P=0.001).

Conclusion: The results of the current study demonstrated that GERD patients have small airway disease even in the absence of respiratory symptoms.

Keywords: Gastroesophageal reflux, Lung function, Plethysmography, Airway resistance, Oscillometry.

(Please cite as Nazemiyeh M, Nouri-Vaskeh M, Somi MH, Saeedi E, Sharifi A. Lung function parameters in patients with gastroesophageal reflux without respiratory symptoms: a case-control study. Gastroenterol Hepatol Bed Bench 2019;12(4):287-291).



Gastroesophageal reflux, Lung function, Plethysmography, Airway resistance, Oscillometry.


Kahrilas PJ. Clinical practice. Gastroesophageal reflux disease. New Engl J Med 2008;359:1700-7.

El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2014;63:871-80.

Somi M FS, Nasseri-Moghaddam S, Jazayeri E, Mirinezhad S, Godrati S, Golchin M. Prevalence and risk factors of gastroesophageal reflux disease in Tabriz, Iran. Iran J Public Health 2008;37:85-0.

Najafimehr H, Ashtari S, Mohaghegh Shalmani H, Fazeli Z, Yadegari H, Taherinejad H, et al. Influence of working in auto factory on gastroesophageal reflux disease. Gastroenterol Hepatol Bed Bench 2018;11:S1-7.

Liuzzo JP, Ambrose JA. Chest pain from gastroesophageal reflux disease in patients with coronary artery disease. Cardiol Rev 2005;13:167-73.

Sharifi A, Ansarin K. Effect of gastroesophageal reflux disease on disease severity and characteristics of lung functional changes in patients with asthma. J Cardiovascular Thoracic Res 2014;6:223-8.

Silva CE, Niedermeier BT, Portinho F. Reflux Laryngitis: Correlation between the Symptoms Findings and Indirect Laryngoscopy. Int Archive Otorhinolaryngol 2015;19:234-7.

Francis DO. Chronic Cough and Gastroesophageal Reflux Disease. Gastroenterol Hepatol 2016;12:64-6.

Lin YH, Chang TS, Yao YC, Li YC. Increased Risk of Chronic Sinusitis in Adults With Gastroesophgeal Reflux Disease: A Nationwide Population-Based Cohort Study. Med 2015;94:e1642.

Chait MM. Gastroesophageal reflux disease: Important considerations for the older patients. World J Gastrointest Endosc 2010;2:388-96.

Fukaya M, Abe T, Nagino M. Rapid progressive long esophageal stricture caused by gastroesophageal reflux disease after pylorus-preserving pancreatoduodenectomy. BMC Surg 2016;16:19.

Dietz J, Meurer L, Maffazzoni DR, Furtado AD, Prolla JC. Intestinal metaplasia in the distal esophagus and correlation with symptoms of gastroesophageal reflux disease. Dis Esophagus 2003;16:29-32.

Mikolasevic I, Bokun T, Filipec Kanizaj T. Gastroesophageal reflux disease, Barrett esophagus, and esophageal adenocarcinoma - where do we stand? Croatian Med J 2018;59:97-9.

Cook MB, Corley DA, Murray LJ, Liao LM, Kamangar F, Ye W, et al. Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). PLoS ONE 2014;9:e103508.

Stein MR. Possible mechanisms of influence of esophageal acid on airway hyperresponsiveness. Am J Med 2003;115:55S-9.

Mastronarde JG. Is There a Relationship Between GERD and Asthma? Gastroenterol Hepatol 2012;8:401-3.

Ates F, Vaezi MF. Insight Into the Relationship Between Gastroesophageal Reflux Disease and Asthma. Gastroenterol Hepatol 2014;10:729-36.

Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J 2005;26:153-61.

Nasseri-Moghaddam S, Razjouyan H, Habibi R, Rafaat-Zand K, Ahrari B, Nouraie M, et al. Reliability, validity, and feasibility of the Mayo gastroesophageal reflux questionnaire (GERQ) in a Persian-speaking population”. Iran J Public Health 2008;37:64-74.

Maleki I, Masoudzadeh A, Khalilian A, Daheshpour E. Quality of life in patients with gastroesophageal reflux disease in an Iranian population. Gastroenterol Hepatol Bed Bench 2013;6:96-100.

Souza RF, Huo X, Mittal V, Schuler CM, Carmack SW, Zhang HY, et al. Gastroesophageal reflux might cause esophagitis through a cytokine-mediated mechanism rather than caustic acid injury. Gastroenterology 2009;137:1776-84.

Broers C, Tack J, Pauwels A. Review article: gastro-oesophageal reflux disease in asthma and chronic obstructive pulmonary disease. Aliment Pharmacol Ther 2018;47:176-91.

Bonacin D, Fabijanic D, Radic M, Puljiz Z, Trgo G, Bratanic A, et al. Gastroesophageal reflux disease and pulmonary function: a potential role of the dead space extension. Int Med J Exp Clin Res 2012;18:CR271-5.

Morehead RS. Gastro-oesophageal reflux disease and non-asthma lung disease. Eur Respir Rev 2009;18:233-43.

Manjunath H, Venkatesh D, Jalihal U, Kumar MP. An Altered Pulmonary Function–A Cause or Consequence of Gastro Esophageal Reflux Disease (GERD). Al Ameen J Med Sci 2011;4:391-5.

Mise K, Capkun V, Jurcev-Savicevic A, Sundov Z, Bradaric A, Mladinov S. The influence of gastroesophageal reflux in the lung: a case-control study. Respirolology 2010;15:837-42.

de la Hoz RE, Christie J, Teamer JA, Bienenfeld LA, Afilaka AA, Crane M, et al. Reflux symptoms and disorders and pulmonary disease in former World Trade Center rescue and recovery workers and volunteers. J Occup Environ Med 2008;50:1351-4.

DOI: https://doi.org/10.22037/ghfbb.v12i4.1650