RT Journal Article
SR Electronic
T1 PWE-110 Gastro-oesophageal reflux in cystic fibrosis: exploring the impact on lung disease
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP A181
OP A183
DO 10.1136/gutjnl-2017-314472.355
VO 66
IS Suppl 2
A1 RW Lord
A1 JS Pearson
A1 PJ Barry
A1 PJ Whorwell
A1 RB Jones
A1 PS McNamara
A1 R Beynon
A1 AM Jones
A1 JA Smith
YR 2017
UL http://gut.bmj.com/content/66/Suppl_2/A181.3.abstract
AB Introduction Studies have shown large amounts of gastro-oesophageal reflux (GOR) in CF patients, which frequently has characteristics which may favour aspiration - asymptomatic, proximal oesophageal extent and supine. Exposure to refluxate may worsen CF lung disease, as it contains acid, digestive enzymes and microbes, which can include respiratory pathogens. We aim to establish if there is a relationship between GOR and CF lung disease.Method We are conducting a prospective observational study in stable CF patients, measuring oesophageal reflux with combined pH and impedance (pH-MII) and reflux symptoms using the RESQ-7 questionnaire. In a preliminary analysis we have collected retrospective data from the medical records for lung function and number of courses of intravenous antibiotics.Results 21 of 30 recruited completed the study (mean age 28 years, mean FEV1 50% predicted, 19 males). Total number of reflux episodes was increased in 72% (median 89, IQR 68–132, normal range <75 episodes). High risk reflux (increased proximal and/or supine reflux) was noted in 62%. Non-acid events (median 54, IQR 21–78) were more frequent than acid events (median 36.5, IQR 13–66), but 14/21 were on acid suppression medications. 5/21 had increased total reflux parameters (median 89, IQR 68–98), but on RESQ-7 had no symptoms.Interestingly, number of intravenous antibiotic treatments positively correlated with total reflux events (r=0.45, p=0.004) and suggested potential trends with high risk parameters (e.g. proximal reflux r=0.37, p=0.1). However there were no correlation between reflux parameters and spirometry.Conclusion CF patients have large amounts of ‘high-risk’ reflux, and our data suggests a potential relationship between reflux severity and the number of pulmonary exacerbations, represented by the requirement for intravenous antibiotics. To explore this further a reliable biomarker of aspiration, such as sputum pepsin, is required.Disclosure of Interest None Declared