Lung Transplant Patients Benefit By Anti-Reflux Surgery
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Case counts at hospitals show that many patients with end-stage lung disease also have GERD or gastro-oesophageal Reflux Disease (or acid reflux). Such patients have a damaged mucosal stomach lining or a weak sphincter that separates the stomach from the oesophagus. This causes the stomach contents to flow back or leak into the osesophagus and cause heartburn etc. (1)
Luckily for the lung disease patients, there is now hope with a corrective surgery that treats GERD.
A study conducted by the researchers at the University Of Pittsburgh School Of Medicine pointed out that patients of idiopathic pulmonary fibrosis or cystic fibrosis can now seek comfort in their findings. The findings suggested that esophageal testing should be performed more frequently among these patients to determine if anti-reflux surgery is needed. If it is needed it should then be performed on them.
GERD is also associated with the occurrence of Bronchiolitis Obliterans Syndrome (BOS). BOS is a non-reversible lung disease in which either fibrosis or inflammation compresses the bronchioles (tiny air ducts) partially or completely obliterates it causing death of the patient. It is suspected that micro-aspiration into the lungs due to GERD sets the stage for BOS. (2)
As per Toshitaka Hoppo, M.D., Ph.D., research assistant professor, Department of Cardiothoracic Surgery, Pitt School of Medicine, “almost one-half of the patients in our series did not have symptoms but were having clinically silent exposure to gastric fluid. Based on this finding, there should be a very low threshold for esophageal testing in this patient population.” (3)
The study examined the history of 43 end-stage pulmonary disease patients who had GERD as well, and were on medication that prevented flow-back of fluid from stomach to esophagus. Out of the 43, 19 were slated for a lung transplant and 24 had already undergone the transplant. However, they all exhibited symptoms of GERD despite the medication.
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