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Pulmonary Medicine
Volume 2011 (2011), Article ID 395020, 6 pages
http://dx.doi.org/10.1155/2011/395020
Review Article

Gastro-Oesophageal Reflux in Noncystic Fibrosis Bronchiectasis

1Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC 3010, Australia
2Department of Physiotherapy, The Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia
3Department of Medicine, Monash University, Melbourne, VIC 3088, Australia
4Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia

Received 15 July 2011; Accepted 25 August 2011

Academic Editor: N. Ambrosino

Copyright © 2011 Annemarie L. Lee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The clinical presentation of noncystic fibrosis bronchiectasis may be complicated by concomitant conditions, including gastro-oesophageal reflux (GOR). Increased acidic GOR is principally caused by gastro-oesophageal junction incompetence and may arise from lower oesophageal sphincter hypotension, including transient relaxations, hiatus hernia, and oesophageal dysmotility. Specific pathophysiological features which are characteristic of respiratory diseases including coughing may further increase the risk of GOR in bronchiectasis. Reflux may impact on lung disease severity by two mechanisms, reflex bronchoconstriction and pulmonary microaspiration. Symptomatic and clinically silent reflux has been detected in bronchiectasis, with the prevalence of 26 to 75%. The cause and effect relationship has not been established, but preliminary reports suggest that GOR may influence the severity of bronchiectasis. Further studies examining the implications of GOR in this condition, including its effect across the disease spectrum using a combination of diagnostic tools, will clarify the clinical significance of this comorbidity.