THE EFFECTS OF ANTIREFLUX THERAPY ON PULMONARY-FUNCTION IN PATIENTS WITH SEVERE GASTROESOPHAGEAL REFLUX DISEASE

Objectives: Gastroesophageal reflux can induce bronchospasm, and antir eflux therapy has been shown to improve pulmonary function in patients who have gastroesophageal reflux disease (GERD) associated with asthm a. Our objective was to study the pulmonary effects of antireflux ther apy in patients who had severe GERD without clinically apparent lung d isease. Methods: In a Department of Veterans Affairs Cooperative Study , patients who had complicated GERD without important lung disease wer e randomly assigned to receive one of three types of antireflux treatm ent, including two kinds of medical therapy and a surgical therapy. Pa tients had pulmonary function tests (PFTs), including total lung capac ity, residual volume, forced vital capacity, forced expiratory volume in 1 s, maximal midexpiratory flow, and diffusing capacity for carbon monoxide. Results: Two hundred forty-seven patients (243 men, four wom en; mean age 58 yr) entered the randomized trial, and 151 returned for PFTs at 1 yr. For the entire study group and for all three treatment groups, mean values for PFTs at 1 yr did not differ significantly from those at baseline. Even in subgroups of patients whose baseline PFTs were abnormal and whose esophagitis had healed completely, there were no significant changes in results of PFTs. Conclusions: For veteran pa tients with severe GERD and no obvious lung disease, 1 yr of antireflu x therapy had no important effect on pulmonary function. These finding s suggest that GERD is not commonly associated with inapparent, revers ible pulmonary dysfunction.