Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Gastroesophageal reflux symptoms are not sufficient to guide esophageal function testing in lung transplant candidates.

Publication ,  Journal Article
Posner, S; Zheng, J; Wood, RK; Shimpi, RA; Hartwig, MG; Chow, S-C; Leiman, DA
Published in: Dis Esophagus
May 1, 2018

Gastroesophageal reflux disease and esophageal dysmotility are prevalent in patients with advanced lung disease and are associated with graft dysfunction following lung transplantation. As a result, many transplant centers perform esophageal function testing as part of the wait-listing process but guidelines for testing in this population are lacking. The aim of this study is to describe whether symptoms of gastroesophageal reflux correlate with abnormal results on pH-metry and high-resolution manometry and can be used to identify those who require testing. We performed a retrospective cohort study of 226 lung transplant candidates referred for high-resolution manometry and pH-metry over a 12-month period in 2015. Demographic data, results of a standard symptom questionnaire and details of esophageal function testing were obtained. Associations between the presence of symptoms and test results were analyzed using Fisher's exact tests and multivariable logistic regression. The most common lung disease diagnosis was interstitial lung disease (N = 131, 58%). Abnormal pH-metry was seen in 116 (51%) patients and the presence of symptoms was significantly associated with an abnormal study (p < 0.01). Dysmotility was found in 98 (43%) patients, with major peristaltic or esophageal outflow disorders in 45 (20%) patients. Symptoms were not correlated with findings on esophageal high-resolution manometry. Fifteen of 25 (60%) asymptomatic patients had an abnormal manometry or pH-metry. These results demonstrate that in patients with advanced lung disease, symptoms of gastroesophageal reflux increase the likelihood of elevated acid exposure on pH-metry but were not associated with dysmotility. Given the proportion of asymptomatic patients with abnormal studies and associated post-transplant risks, a practice of universal high-resolution manometry and pH-metry testing in this population is justifiable.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Dis Esophagus

DOI

EISSN

1442-2050

Publication Date

May 1, 2018

Volume

31

Issue

5

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Reproducibility of Results
  • Postoperative Complications
  • Middle Aged
  • Manometry
  • Male
  • Lung Transplantation
  • Lung Diseases
  • Humans
  • Gastroesophageal Reflux
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Posner, S., Zheng, J., Wood, R. K., Shimpi, R. A., Hartwig, M. G., Chow, S.-C., & Leiman, D. A. (2018). Gastroesophageal reflux symptoms are not sufficient to guide esophageal function testing in lung transplant candidates. Dis Esophagus, 31(5). https://doi.org/10.1093/dote/dox157
Posner, S., J. Zheng, R. K. Wood, R. A. Shimpi, M. G. Hartwig, S. -. C. Chow, and D. A. Leiman. “Gastroesophageal reflux symptoms are not sufficient to guide esophageal function testing in lung transplant candidates.Dis Esophagus 31, no. 5 (May 1, 2018). https://doi.org/10.1093/dote/dox157.
Posner S, Zheng J, Wood RK, Shimpi RA, Hartwig MG, Chow S-C, et al. Gastroesophageal reflux symptoms are not sufficient to guide esophageal function testing in lung transplant candidates. Dis Esophagus. 2018 May 1;31(5).
Posner, S., et al. “Gastroesophageal reflux symptoms are not sufficient to guide esophageal function testing in lung transplant candidates.Dis Esophagus, vol. 31, no. 5, May 2018. Pubmed, doi:10.1093/dote/dox157.
Posner S, Zheng J, Wood RK, Shimpi RA, Hartwig MG, Chow S-C, Leiman DA. Gastroesophageal reflux symptoms are not sufficient to guide esophageal function testing in lung transplant candidates. Dis Esophagus. 2018 May 1;31(5).
Journal cover image

Published In

Dis Esophagus

DOI

EISSN

1442-2050

Publication Date

May 1, 2018

Volume

31

Issue

5

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Reproducibility of Results
  • Postoperative Complications
  • Middle Aged
  • Manometry
  • Male
  • Lung Transplantation
  • Lung Diseases
  • Humans
  • Gastroesophageal Reflux