Tibbling L
Department of Otorhinolaryngology, University Hospital, Linköping, Sweden.
Acta Otolaryngol. 1993 May;113(3):405-8. doi: 10.3109/00016489309135835.
A new theory was tested that swallowing the wrong way is the cause of the strong correlation between bronchial symptoms and gastroesophageal reflux disease (GERD). One hundred and nineteen patients who were operated on for hiatal hernia and GERD were compared with 89 patients treated with the proton pump inhibitor omeprazole concerning bronchial symptoms before and after treatment. Both groups had a frequency of cough of 34% before treatment. Omeprazole did not give any significant relief of cough, whereas patients who were operated on with fundoplication and crural repair showed a highly significant reduction of cough and bronchitis. It is believed that the distal anchoring of the longitudinal esophageal muscle by surgery improves esophageal transit and restores the delicate coordination in the swallowing centre between deglutition, the opening of the upper esophageal sphincter, and the epiglottic closure of the laryngeal entrance. It is concluded that the main reason for chronic bronchitis in patients with GERD is intermittent aspiration due to partial mis-swallowing.
一种新理论得到验证，即吞咽方式错误是支气管症状与胃食管反流病（GERD）之间强相关性的原因。将119例因食管裂孔疝和GERD接受手术的患者与89例接受质子泵抑制剂奥美拉唑治疗的患者在治疗前后的支气管症状进行了比较。两组治疗前咳嗽频率均为34%。奥美拉唑对咳嗽无明显缓解作用，而接受胃底折叠术和膈肌脚修复术的患者咳嗽和支气管炎症状显著减轻。据信，手术使食管纵肌在远端固定，改善了食管转运，并恢复了吞咽中枢在吞咽、食管上括约肌开放和喉入口会厌关闭之间的微妙协调。得出的结论是，GERD患者慢性支气管炎的主要原因是部分误吞咽导致的间歇性误吸。
