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Increased acid gastro-oesophageal reflux (GOR) has been reported in patients with cystic fibrosis (CF). However, its prevalence, characteristics, association with gastric aspiration and impact on respiration are not completely understood. In the study by Blondeau and colleagues, patients with CF underwent: impedance-pH measurement for reflux detection; assessment of the association between reflux and cough; and measurement of bile acids in saliva and bronchoalveolar lavage as surrogate markers for gastric aspiration. Increased GOR was present in 28/33 patients and this was mainly due to acid reflux. However, a small proportion of the patients demonstrated a reflux pattern of mixed acid and weakly acidic reflux, whereas some had mainly weakly acidic reflux. Importantly, reflux did not seem to be secondary to cough because most of the time reflux preceded cough and not the opposite. Gastric aspiration was common, as evidenced by bile acids in saliva in 16/38 patients and in bronchoalveolar lavage
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