High incidence of oesophageal dysmotility in unexplained respiratory symptoms

We have previously suggested that oesophageal dysfunction may underlie a number of otherwise unexplained respiratory symptoms particularly chronic cough. However on conventional testing of oesophageal function using pH and impedance techniques few patients are abnormal. We have compared patients with unexplained respiratory symptoms with a control group with dyspepsia and heartburn using High Resolution Oesophageal Manometry.121 patients were studied, 61 with respiratory complaints and 60 with primarily gastrointestinal symptoms. Respiratory patients consisted of 38 females, combined mean age of 56, range (18 – 81) and a matched group of GI patients, 39 female, mean age 57, range (19 – 81). The majority of the respiratory patients had chronic cough, 11 primarily breathlessness.11 had asthma and in two patients CT demonstrated bronchiectasis. HROM revealed a significantly greater degree of peristaltic dysfunction in the respiratory group with over half (57%) demonstrating either failed or weak contraction (GORD 42%). Acid reflux was more common in GORD (44%) versus respiratory (39%). Mean DeMeester score was 22.6 versus 16.1, time below pH 4 8.5% versus 4.5%) p = 0.05. Whilst resting lower oesophageal sphincter pressure was similar but there was a significant difference between groups in the LOS contraction on inspiration. The respiratory patients increased LOS pressure to 46 mmHg versus 33 in the GORD group.Thus respiratory patients with unexplained symptoms have ...

Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Burke, J., Jackson, W., Faruqi, S., Morice, A. Tags: 5.2 Monitoring Airway Disease Source Type: research