Gastro-oesophageal reflux [GOR] is a common companion for any patient with a chronic respiratory condition and may even be the cause of some chronic lung problems.

In PCD it may co-exist and it may exacerbate symptoms that already exist.

Anybody with a chronic cough is likely to have an increased risk of reflux due to raised intra-abdominal pressures during bouts of coughing. If patients appear not to be responding to maximal therapy to treat the lung consequences of PCD then GOR should always be looked for and treated. Reflux and aspiration may lead to infection and inflammation in the lungs than can greatly enhance the progression of the lung disease.

Treatment is usually medical with a combination of antacids and pro-kinetic agents. Neutralising gastric acid will reduce both the pain [heartburn] and inflammatory responses in the lungs if aspiration does occur. Prokinetics are agents that increase the gut motility [peristalsis] to enhance stomach emptying. Pooling of liquid and food in the stomach greatly increases the risk that stomach contents can wash up and down in the oesophagus and therefore lead to aspiration events.

Dual therapy is more common in young children, but can be useful in all ages. Occasionally surgical intervention will be required to prevent aspiration as a lung protective measure.

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