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Nighttime Reflux Linked to Lung Damage in Otherwise Healthy Adults

Swedish researchers found that people experiencing weekly nocturnal heartburn show a 25% higher risk of bronchial wall thickening and other lung abnormalities on CT scans. The discovery, drawn from nearly 29,000 adults, suggests acid reflux may damage respiratory tissue and could shift how clinicians assess risk in asymptomatic populations.

Originaltitel: Nocturnal gastro-oesophageal reflux and pulmonary abnormalities on chest CT in a general population: the Swedish CArdioPulmonary BioImage Study

Abstrakt

Background: Nocturnal gastro-oesophageal reflux (nGER) is common in people with respiratory diseases, but its association with pulmonary abnormalities is not known. Aim: Investigate the association between nGER and pulmonary abnormalities on chest CT in an adult general population. Methods: In total, 28846 individuals from the general population aged 50-64 years completed questionnaires and underwent chest CT, in the Swedish CArdioPulmonary BioImage Study (www.scapis.org). Participants with nGER symptoms on ≥1 night per week were defined as having nGER. Chest CT was evaluated for bronchial wall thickening, bronchiectasis, reticular abnormalities, honeycombing, cysts and ground glass opacities. Ever-smoking, current asthma, inflammatory bowel disease and autoimmune disease were defined as risk factors for pulmonary abnormalities. Analyses were adjusted for sex, age, body mass index, education level and study centre. Results: The prevalence of nGER was 9.4%. Among participants with risk factors for pulmonary abnormalities (n=4004), having nGER was positively associated with bronchial wall thickening (adjusted OR (aOR) (95%CI): 1.25 (1.07 to 1.48)) and reticular abnormalities (aOR (95%CI): 1.51 (1.04 to 2.17)), but negatively associated with cysts (aOR (95%CI): 0.68 (0.48 to 0.97)). Among participants without risk factors for CT abnormalities (n=2555), nGER did not relate with pulmonary abnormalities. Conclusions: In a middle-aged general population, nGER was not associated with pulmonary abnormalities on chest CT. However, in the presence of other risk factors for pulmonary abnormalities, nGER was associated with bronchial wall thickening and reticular abnormalities. Persons with nGER and risk factors for pulmonary abnormalities should, therefore, be evaluated for respiratory disease and treated appropriately.

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