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First published online on March 30, 2007
Chest, doi:10.1378/chest.06-2280
doi:10.1378/chest.06-2280
(Chest. 2007; 131:1825-1830)
© 2007 American College of Chest Physicians
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Prevalence of Gastroesophageal Reflux Disease in Patients With Nontuberculous Mycobacterial Lung Disease*

Won-Jung Koh, MD; Jun Haeng Lee, MD; Yong Soo Kwon, MD; Kyung Soo Lee, MD; Gee Young Suh, MD; Man Pyo Chung, MD; Hojoong Kim, MD, FCCP and O. Jung Kwon, MD

* From the Division of Pulmonary and Critical Care Medicine (Drs. Koh, Y.S. Kwon, Suh, Chung, Kim, and O.J. Kwon) and Gastroenterology (Dr. J.H. Lee), Department of Medicine (Dr. K.S. Lee), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Correspondence to: O. Jung Kwon, MD, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135–710, Republic of Korea; e-mail: ojkwon{at}smc.samsung.co.kr

Abstract

Background: Knowledge of the relationship between respiratory disorders and gastroesophageal reflux disease (GERD) is increasing. However, the association between GERD and pulmonary disease caused by nontuberculous mycobacteria (NTM) has not been studied in detail. We investigated the prevalence of GERD in patients with the nodular bronchiectatic form of NTM lung disease.

Methods: Fifty-eight patients with the nodular bronchiectatic form of NTM lung disease underwent ambulatory 24-h esophageal pH monitoring. Of the 58 patients, 27 patients were identified as having Mycobacterium avium complex infection (15 with Mycobacterium intracellulare and 12 with M avium), and 31 patients had Mycobacterium abscessus pulmonary infection.

Results: The prevalence of GERD in patients with the nodular bronchiectatic form of NTM lung disease was 26% (15 of 58 patients). Only 27% (4 of 15 patients) had typical GERD symptoms. No statistically significant differences were found between patients with GERD and those without GERD with regard to age, sex, body mass index, or pulmonary function test results. However, patients with GERD were more likely to have a sputum smear that was positive for acid-fast bacilli (12 of 15 patients, 80%), compared with patients without GERD (19 of 43 patients, 44%) [p = 0.033]. In addition, bronchiectasis and bronchiolitis were observed in more lobes in patients with GERD than in patients without GERD (p = 0.008 and p = 0.005, respectively).

Conclusions: Patients with the nodular bronchiectatic form of NTM lung disease have a high prevalence of increased esophageal acid exposure, usually without typical GERD symptoms.

Key Words: atypical mycobacteria • gastroesophageal reflux • lung diseases • Mycobacterium avium complex






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