{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:38:09Z","timestamp":1791045489747,"version":"4.1.0"},"reference-count":30,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2011,6]]},"abstract":"<jats:p>CONTEXT: Gastroesophageal reflux disease (GERD) is common in patients with respiratory disorders and interstitial lung fibrosis from diverse disease processes. However, a cause-effect relationship has not been well demonstrated. It is hypothesized that there might be more than a coincidental association between GERD and interstitial lung damage. There is still confusion about the diagnostic steps necessary to confirm the presence of GERD, and about the role of effective control of GERD in the natural history of these respiratory disorders. OBJECTIVES: To determine the prevalence of GERD in patients with respiratory disorders and lung involvement; the sensitivity of symptoms in the diagnosis of GERD; and the role of esophageal function tests (manometry and 24- hour pH monitoring) in the diagnosis and treatment of these patients. METHODS: Prospective study based on a database of 44 patients (29 females) with respiratory disorders: 16 patients had idiopathic pulmonary fibrosis, 11 patients had systemic sclerosis associated interstitial lung disease, 2 patients had polymyositis associated interstitial lung disease, 2 patients had Sj\u00f6gren associated interstitial lung disease, 2 patients had rheumatoid artrithis associated interstitial lung disease, 1 patient had undifferentiated connective tissue diseases associated interstitial lung disease and 10 patients had sarcoidosis. The average forced vital capacity (% predicted) was 64.3%. All patients had esophageal function tests. RESULTS: Thirty patients (68%) had pathologic reflux (average DeMeester score: 45, normal &lt;14.7). The average number of reflux episodes recorded 20 cm above the lower esophageal sphincter was 24. Sensitivity and specificity of heartburn were 70% and 57%, of regurgitation 43% and 57%, and of dysphagia 33% and 64%. Twelve patients with GERD underwent a laparoscopic fundoplication which was tailored to the manometric profile: three patients in which peristalsis was normal had a total fundoplication (360\u00b0) and nine patients in which the peristalsis was absent had a partial anterior fundoplication (180\u00b0). CONCLUSIONS: The results of our study show that: (a) abnormal reflux was present in about 2\/3 of patients with respiratory disorders (idiophatic pulmonary fibrosis, connective tissue disorders and sarcoidosis), and it extended to the upper esophagus in most patients; (b) the sensitivity and specificity of reflux symptoms was very low; and (c) esophageal function tests were essential to establish the diagnosis of abnormal reflux, to characterize the esophageal function and guide therapy. Long term follow-up will be necessary to determine if control of reflux alters the natural history of these respiratory disorders.<\/jats:p>","DOI":"10.1590\/s0004-28032011000200002","type":"journal-article","created":{"date-parts":[[2011,6,20]],"date-time":"2011-06-20T13:16:35Z","timestamp":1308575795000},"page":"91-97","source":"Crossref","is-referenced-by-count":40,"title":["Interstitial lung disease and gastroesophageal reflux disease: key role of esophageal function tests in the diagnosis and treatment"],"prefix":"10.1590","volume":"48","author":[{"given":"Renato Vianna","family":"Soares","sequence":"first","affiliation":[{"name":"University of Chicago, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Forsythe","sequence":"additional","affiliation":[{"name":"University of Chicago, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Hogarth","sequence":"additional","affiliation":[{"name":"University of Chicago, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadera J.","family":"Sweiss","sequence":"additional","affiliation":[{"name":"University of Chicago, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imre","family":"Noth","sequence":"additional","affiliation":[{"name":"University of Chicago, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco G.","family":"Patti","sequence":"additional","affiliation":[{"name":"University of Chicago, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1080\/03009740600844381","article-title":"Prevalence of interstitial lung involvement in patients with connective tissue diseases assessed with high-resolution computed tomography","volume":"35","author":"Afeltra A","year":"2006","journal-title":"Scand J Rheumatol","ISSN":"https:\/\/id.crossref.org\/issn\/0300-9742","issn-type":"print"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1164\/ajrccm.165.2.ats01","article-title":"International multidisciplinary consensus classification of idiopathic interstitial pneumonias","volume":"165","year":"2002","journal-title":"Am J Respir Crit Care Med","ISSN":"https:\/\/id.crossref.org\/issn\/1073-449X","issn-type":"print"},{"key":"ref3","first-page":"1182","article-title":"Prevalence of gastroesophageal reflux disease in patients with idiopathic pulmonary fibrosis","volume":"35","author":"Bandeira CD","year":"2009","journal-title":"J Bras Pneumol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/0002-9343(69)90044-8","article-title":"Pathologic observations in systemic sclerosis (scleroderma). A study of fifty-eight autopsy cases and fifty-eight matched controls","volume":"46","author":"D'Angelo WA","year":"1969","journal-title":"Am J Med","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9343","issn-type":"print"},{"key":"ref5","first-page":"25","article-title":"Normal and abnormal proximal esophageal acid exposure: results of ambulatory dual-probe pH monitoring","volume":"88","author":"Dobhan R","year":"1993","journal-title":"Am J Gastroenterol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9270","issn-type":"print"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1016\/j.athoracsur.2005.03.106","article-title":"Prevalence of gastroesophageal reflux in end-stage lung disease candidates for lung transplant","volume":"80","author":"D'Ovidio F","year":"2005","journal-title":"Ann Thorac Surg","ISSN":"https:\/\/id.crossref.org\/issn\/0003-4975","issn-type":"print"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/S0016-5085(97)70168-9","article-title":"Comorbid occurrence of laryngeal or pulmonary disease with esophagitis in United States military veterans","volume":"113","author":"el-Serag HB","year":"1997","journal-title":"Gastroenterology","ISSN":"https:\/\/id.crossref.org\/issn\/0016-5085","issn-type":"print"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/j.rmed.2008.12.018","article-title":"Esophageal involvement and interstitial lung disease in mixed connective tissue disease","volume":"103","author":"Fagundes MN","year":"2009","journal-title":"Respir Med","ISSN":"https:\/\/id.crossref.org\/issn\/0954-6111","issn-type":"print"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1111\/j.1442-2050.2008.00828.x","article-title":"Lung transplantation in patients with connective tissue disorders and esophageal dysmotility","volume":"21","author":"Gasper WJ","year":"2008","journal-title":"Dis Esophagus","ISSN":"https:\/\/id.crossref.org\/issn\/1120-8694","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1001\/archinte.1989.00390030075014","article-title":"Pulmonary disease in progressive systemic sclerosis. A complication of gastroesophageal reflux and occult aspiration?","volume":"149","author":"Johnson DA","year":"1989","journal-title":"Arch Intern Med","ISSN":"https:\/\/id.crossref.org\/issn\/0003-9926","issn-type":"print"},{"key":"ref11","first-page":"325","article-title":"Twenty-four hour pH monitoring of the distal esophagus. A quantitative measure of gastroesophageal reflux","volume":"62","author":"Johnson LF","year":"1974","journal-title":"Am J Gastroenterol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9270","issn-type":"print"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1183\/09031936.05.00034905","article-title":"Standardisation of the single-breath determination of carbon monoxide uptake in the lung","volume":"26","author":"Macintyre N","year":"2005","journal-title":"Eur Respir J","ISSN":"https:\/\/id.crossref.org\/issn\/0903-1936","issn-type":"print"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1002\/bjs.5493","article-title":"Combined multichannel intraluminal impedance-pH monitoring to select patients with persistent gastro-esophageal reflux for laparoscopic Nissen fundoplication","volume":"93","author":"Mainie I","year":"2006","journal-title":"Br J Surg","ISSN":"https:\/\/id.crossref.org\/issn\/0007-1323","issn-type":"print"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/00005537-200302000-00027","article-title":"Laryngopharyngeal reflux identified using a new catheter design: defining normal values and excluding artifacts","volume":"113","author":"Maldonado A","year":"2003","journal-title":"Laryngoscope","ISSN":"https:\/\/id.crossref.org\/issn\/0023-852X","issn-type":"print"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1002\/1529-0131(200108)45:4<346::AID-ART347>3.0.CO;2-L","article-title":"Esophageal involvement and pulmonary manifestations in systemic sclerosis","volume":"45","author":"Marie I","year":"2001","journal-title":"Arthritis Rheum","ISSN":"https:\/\/id.crossref.org\/issn\/0004-3591","issn-type":"print"},{"key":"ref16","first-page":"512","article-title":"Pulmonary fibrosis associated with tracheobronchial aspiration. A study of the frequency of hiatal hernia and gastroesophageal reflux in interstitial pulmonary fibrosis of obscure etiology","volume":"69","author":"Mays EE","year":"1976","journal-title":"Chest","ISSN":"https:\/\/id.crossref.org\/issn\/0012-3692","issn-type":"print"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1183\/09031936.05.00034805","article-title":"Standardisation of spirometry","volume":"26","author":"Miller MR","year":"2005","journal-title":"Eur Respir J","ISSN":"https:\/\/id.crossref.org\/issn\/0903-1936","issn-type":"print"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1023\/A:1005611602100","article-title":"Role of esophageal function tests in diagnosis of gastroesophageal reflux disease","volume":"46","author":"Patti MG","year":"2001","journal-title":"Dig Dis Sci","ISSN":"https:\/\/id.crossref.org\/issn\/0163-2116","issn-type":"print"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.gassur.2005.06.027","article-title":"Idiopathic pulmonary fibrosis: how often is it really idiopathic?","volume":"9","author":"Patti MG","year":"2005","journal-title":"J Gastrointest Surg","ISSN":"https:\/\/id.crossref.org\/issn\/1091-255X","issn-type":"print"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1007\/s11605-008-0674-9","article-title":"Gastroesophageal reflux disease and connective tissue disorders: pathophysiology and implications for treatment","volume":"12","author":"Patti MG","year":"2008","journal-title":"J Gastrointest Surg","ISSN":"https:\/\/id.crossref.org\/issn\/1091-255X","issn-type":"print"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1136\/thx.26.3.300","article-title":"Diffuse pulmonary fibrosis and hiatus hernia","volume":"26","author":"Pearson JE","year":"1971","journal-title":"Thorax","ISSN":"https:\/\/id.crossref.org\/issn\/0040-6376","issn-type":"print"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1183\/09031936.06.00037005","article-title":"High prevalence of abnormal acid gastro-oesophageal reflux in idiopathic pulmonary fibrosis","volume":"27","author":"Raghu G","year":"2006","journal-title":"Eur Respir J","ISSN":"https:\/\/id.crossref.org\/issn\/0903-1936","issn-type":"print"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.dld.2006.05.012","article-title":"Gastro-oesophageal reflux and interstitial lung disease","volume":"38","author":"Salvioli B","year":"2006","journal-title":"Dig Liver Dis"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1164\/rccm.200808-1359OC","article-title":"Gastroesophageal reflux and pulmonary fibrosis in scleroderma: a study using pH-impedance monitoring","volume":"179","author":"Savarino E","year":"2009","journal-title":"Am J Respir Crit Care Med","ISSN":"https:\/\/id.crossref.org\/issn\/1073-449X","issn-type":"print"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1111\/j.1572-0241.2004.04172.x","article-title":"Twenty-four hour ambulatory simultaneous impedance and pH monitoring: a multicenter report of normal values from 60 healthy volunteers","volume":"99","author":"Shay S","year":"2004","journal-title":"Am J Gastroenterol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9270","issn-type":"print"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1136\/gut.49.1.145","article-title":"Classification of esophageal motility abnormalities","volume":"49","author":"Spechler SJ","year":"2001","journal-title":"Gut","ISSN":"https:\/\/id.crossref.org\/issn\/0017-5749","issn-type":"print"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/j.jtcvs.2006.09.085","article-title":"Gastroesophageal reflux in patients with idiopathic pulmonary fibrosis referred for lung transplantation","volume":"133","author":"Sweet MP","year":"2007","journal-title":"J Thorac Cardiovasc Surg","ISSN":"https:\/\/id.crossref.org\/issn\/0022-5223","issn-type":"print"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/j.gassur.2004.08.001","article-title":"Omeprazole does not reduce gastroesophageal reflux: new insights using multichannel intraluminal impedance technology","volume":"8","author":"Tamhankar AP","year":"2004","journal-title":"J Gastrointest Surg","ISSN":"https:\/\/id.crossref.org\/issn\/1091-255X","issn-type":"print"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"1804","DOI":"10.1164\/ajrccm.158.6.9804105","article-title":"Increased prevalence of gastroesophageal reflux in patients with idiopathic pulmonary fibrosis","volume":"158","author":"Tobin RW","year":"1998","journal-title":"Am J Respir Crit Care Med","ISSN":"https:\/\/id.crossref.org\/issn\/1073-449X","issn-type":"print"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1183\/09031936.05.00035005","article-title":"Standardisation of the measurement of lung volumes","volume":"26","author":"Wanger J","year":"2005","journal-title":"Eur Respir J","ISSN":"https:\/\/id.crossref.org\/issn\/0903-1936","issn-type":"print"}],"container-title":["Arquivos de Gastroenterologia"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/ag\/v48n2\/a02v48n2.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,7]],"date-time":"2024-04-07T16:46:36Z","timestamp":1712508396000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0004-28032011000200002&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,6]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2011,6]]}},"alternative-id":["S0004-28032011000200002"],"URL":"https:\/\/doi.org\/10.1590\/s0004-28032011000200002","relation":{},"ISSN":["0004-2803"],"issn-type":[{"value":"0004-2803","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,6]]}}}