W1070 Non-Acid Reflux Burden is a Predictor of Bacterial Lung Infections

Abstract

typical (HB/reg.) (23%) or extra-esophageal (77%) symptom complex (cough-38%, chest pain-30%, hoarseness-22%, asthma-5%, post nasal drip 5%) underwent 48 hour Bravo pH monitoring on week off acid suppressive therapy. % time pH 5.5%, upright > 8.0% and supine > 3.0%. pH profile as well as demographic data (age, gender, BMI) were compared. Results: 216/296 (73%) pts had abnormal esophageal acid exposure: 95/216 (44%) in both upright and supine positions; 82/216 (38%) in the upright only and 39/216 (18%) in the supine only positions. The median (interquartile) number of reflux events was significantly (p<0.001) higher in pts with upright and supine reflux [86 (59 to106)] than those with supine only [52(37 to 73)] or upright only [62 (43 to 93)] reflux pattern. HB and regurgitation were significantly (p=0.03) higher in those with supine only reflux than upright only group. Prevalence of abnormal esophageal acid exposure was similar in those with chief complaint of HB/reg (65%) to those with extra-esophageal symptom's with (54%) or without (68%) concomitant HB/reg. (p=0.3). Conclusions: 1) Reflux disease defined physiologically by abnormal esophageal acid exposure off acid suppressive therapy is common (73%) in pts referred with extra-esophageal symptom's and occurs most commonly in the upright position. 2) The widely held notion that pts with extra-esophageal symptoms without concomitant HB/regurgitation are less likely to have reflux should be re-evaluated.