Cystic fibrosis: A surgical matter?

Tamara Caldaro, Federico Alghisi, Paola De Angelis, Maria Carmen Garganese, Francesca Rea, Milena Pizzoferro, Maria Felicia Villani, Erminia Francesca Romeo, Filippo Torroni, Francesca Foschia, Rosa Alba Gambitta, Giovanni Federici, Vincenzina Lucidi, Luigi Dall'Oglio

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Gastroesophageal reflux disease (GERD) is very common in patients with chronic lung diseases. We evaluated the incidence of GERD in young patients with cystic fibrosis (CF) and defined the characteristics of gastroesophageal reflux episodes analyzed by pH-multichannel intraluminal impedance (pH-MII) and esophagogastric scintigraphy. Patients and methods Since 2010, 31 patients with CF underwent pH-MII. Scintigraphy and upper endoscopy were performed in positive GERD patients. Forced expiratory volume in 1 second (FEV1%) predicted was detected. Results pH-MII was positive in 17/31 (54.8%) patients (mean age: 12.4 years; range: 4-17 years). pH monitoring detected an average of 64.6 acid reflux events 4.4 episodes > 5 minutes in duration. The DeMeester score was 38.5. Impedance identified a mean number of reflux episodes of 66 (65.2% acid; 32% weakly acidic; 2.8% nonacidic), 28% of which reached the proximal esophagus. Esophageal transit and gastric emptying were delayed in 6/13 (46.1%) and in 5/15 (33.3%) cases, respectively. No differences were found in lung function between positive and negative GERD patients (P = 0.88). Conclusions Pediatric patients with CF have a high incidence of GERD with acidic events. These patients should be investigated with pH-MII and scintigraphy in order to make an early diagnosis and determine the most appropriate follow-up.

Original languageEnglish
Pages (from-to)753-758
Number of pages6
JournalJournal of Pediatric Surgery
Volume49
Issue number5
DOIs
Publication statusPublished - 2014

Fingerprint

Cystic Fibrosis
Gastroesophageal Reflux
Electric Impedance
Radionuclide Imaging
Acids
Gastric Emptying
Incidence
Forced Expiratory Volume
Esophagus
Endoscopy
Lung Diseases
Early Diagnosis
Chronic Disease
Pediatrics
Lung

Keywords

  • Cystic fibrosis
  • Fundoplication
  • Gastric scintigraphy
  • GERD
  • pH-multichannel intraluminal impedance

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Cystic fibrosis : A surgical matter? / Caldaro, Tamara; Alghisi, Federico; De Angelis, Paola; Garganese, Maria Carmen; Rea, Francesca; Pizzoferro, Milena; Villani, Maria Felicia; Romeo, Erminia Francesca; Torroni, Filippo; Foschia, Francesca; Gambitta, Rosa Alba; Federici, Giovanni; Lucidi, Vincenzina; Dall'Oglio, Luigi.

In: Journal of Pediatric Surgery, Vol. 49, No. 5, 2014, p. 753-758.

Research output: Contribution to journalArticle

@article{0d0bf9a5226144a58306d13f7f5f4b22,
title = "Cystic fibrosis: A surgical matter?",
abstract = "Background Gastroesophageal reflux disease (GERD) is very common in patients with chronic lung diseases. We evaluated the incidence of GERD in young patients with cystic fibrosis (CF) and defined the characteristics of gastroesophageal reflux episodes analyzed by pH-multichannel intraluminal impedance (pH-MII) and esophagogastric scintigraphy. Patients and methods Since 2010, 31 patients with CF underwent pH-MII. Scintigraphy and upper endoscopy were performed in positive GERD patients. Forced expiratory volume in 1 second (FEV1{\%}) predicted was detected. Results pH-MII was positive in 17/31 (54.8{\%}) patients (mean age: 12.4 years; range: 4-17 years). pH monitoring detected an average of 64.6 acid reflux events 4.4 episodes > 5 minutes in duration. The DeMeester score was 38.5. Impedance identified a mean number of reflux episodes of 66 (65.2{\%} acid; 32{\%} weakly acidic; 2.8{\%} nonacidic), 28{\%} of which reached the proximal esophagus. Esophageal transit and gastric emptying were delayed in 6/13 (46.1{\%}) and in 5/15 (33.3{\%}) cases, respectively. No differences were found in lung function between positive and negative GERD patients (P = 0.88). Conclusions Pediatric patients with CF have a high incidence of GERD with acidic events. These patients should be investigated with pH-MII and scintigraphy in order to make an early diagnosis and determine the most appropriate follow-up.",
keywords = "Cystic fibrosis, Fundoplication, Gastric scintigraphy, GERD, pH-multichannel intraluminal impedance",
author = "Tamara Caldaro and Federico Alghisi and {De Angelis}, Paola and Garganese, {Maria Carmen} and Francesca Rea and Milena Pizzoferro and Villani, {Maria Felicia} and Romeo, {Erminia Francesca} and Filippo Torroni and Francesca Foschia and Gambitta, {Rosa Alba} and Giovanni Federici and Vincenzina Lucidi and Luigi Dall'Oglio",
year = "2014",
doi = "10.1016/j.jpedsurg.2014.02.089",
language = "English",
volume = "49",
pages = "753--758",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "5",

}

TY - JOUR

T1 - Cystic fibrosis

T2 - A surgical matter?

AU - Caldaro, Tamara

AU - Alghisi, Federico

AU - De Angelis, Paola

AU - Garganese, Maria Carmen

AU - Rea, Francesca

AU - Pizzoferro, Milena

AU - Villani, Maria Felicia

AU - Romeo, Erminia Francesca

AU - Torroni, Filippo

AU - Foschia, Francesca

AU - Gambitta, Rosa Alba

AU - Federici, Giovanni

AU - Lucidi, Vincenzina

AU - Dall'Oglio, Luigi

PY - 2014

Y1 - 2014

N2 - Background Gastroesophageal reflux disease (GERD) is very common in patients with chronic lung diseases. We evaluated the incidence of GERD in young patients with cystic fibrosis (CF) and defined the characteristics of gastroesophageal reflux episodes analyzed by pH-multichannel intraluminal impedance (pH-MII) and esophagogastric scintigraphy. Patients and methods Since 2010, 31 patients with CF underwent pH-MII. Scintigraphy and upper endoscopy were performed in positive GERD patients. Forced expiratory volume in 1 second (FEV1%) predicted was detected. Results pH-MII was positive in 17/31 (54.8%) patients (mean age: 12.4 years; range: 4-17 years). pH monitoring detected an average of 64.6 acid reflux events 4.4 episodes > 5 minutes in duration. The DeMeester score was 38.5. Impedance identified a mean number of reflux episodes of 66 (65.2% acid; 32% weakly acidic; 2.8% nonacidic), 28% of which reached the proximal esophagus. Esophageal transit and gastric emptying were delayed in 6/13 (46.1%) and in 5/15 (33.3%) cases, respectively. No differences were found in lung function between positive and negative GERD patients (P = 0.88). Conclusions Pediatric patients with CF have a high incidence of GERD with acidic events. These patients should be investigated with pH-MII and scintigraphy in order to make an early diagnosis and determine the most appropriate follow-up.

AB - Background Gastroesophageal reflux disease (GERD) is very common in patients with chronic lung diseases. We evaluated the incidence of GERD in young patients with cystic fibrosis (CF) and defined the characteristics of gastroesophageal reflux episodes analyzed by pH-multichannel intraluminal impedance (pH-MII) and esophagogastric scintigraphy. Patients and methods Since 2010, 31 patients with CF underwent pH-MII. Scintigraphy and upper endoscopy were performed in positive GERD patients. Forced expiratory volume in 1 second (FEV1%) predicted was detected. Results pH-MII was positive in 17/31 (54.8%) patients (mean age: 12.4 years; range: 4-17 years). pH monitoring detected an average of 64.6 acid reflux events 4.4 episodes > 5 minutes in duration. The DeMeester score was 38.5. Impedance identified a mean number of reflux episodes of 66 (65.2% acid; 32% weakly acidic; 2.8% nonacidic), 28% of which reached the proximal esophagus. Esophageal transit and gastric emptying were delayed in 6/13 (46.1%) and in 5/15 (33.3%) cases, respectively. No differences were found in lung function between positive and negative GERD patients (P = 0.88). Conclusions Pediatric patients with CF have a high incidence of GERD with acidic events. These patients should be investigated with pH-MII and scintigraphy in order to make an early diagnosis and determine the most appropriate follow-up.

KW - Cystic fibrosis

KW - Fundoplication

KW - Gastric scintigraphy

KW - GERD

KW - pH-multichannel intraluminal impedance

UR - http://www.scopus.com/inward/record.url?scp=84901009878&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901009878&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2014.02.089

DO - 10.1016/j.jpedsurg.2014.02.089

M3 - Article

C2 - 24851763

AN - SCOPUS:84901009878

VL - 49

SP - 753

EP - 758

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 5

ER -