Sorting out the Relationship Between Esophageal and Pulmonary Disease - 28/10/21

Doi : 10.1016/j.gtc.2021.08.006

Noreen C. Okwara, MD ^a,^b, Walter W. Chan, MD, MPH ^b,^c,^⁎
^a Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
^b Harvard Medical School, Boston, Massachusetts, USA
^c Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA

^∗Corresponding author. Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.Division of Gastroenterology, Hepatology and EndoscopyBrigham and Women's Hospital75 Francis StreetBostonMA02115USA

Résumé

The aim of this review is to explore the relationship between esophageal syndromes and pulmonary diseases considering the most recent data available. Prior studies have shown a close relationship between lung diseases such as asthma, chronic obstructive pulmonary disorders (COPD), Idiopathic pulmonary fibrosis (IPF), and lung transplant rejection and esophageal dysfunction. Although the association has long been demonstrated, the exact relationship remains unclear. Clinical experience has shown a bidirectional relationship where esophageal disease may influence the outcomes of pulmonary disease and vice versa. The impact of esophageal dysfunction on pulmonary disorders may also be related to 2 different mechanisms: the reflux pathway leading to microaspiration and the reflex pathway triggering vagally mediated airway reactions. The aim of this review is to further explore these relationships and pathophysiologic mechanisms. Specifically, we discuss the proposed hypotheses for the relationship between the 2 diseases, as well as the pathophysiology and new developments in clinical management

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Keywords : Esophageal dysfunction, Aspiration, Pulmonary disease, Gastroesophageal reflux disease (GERD), Lung transplant