Comparison of airway responses following tracheal or esophageal acidification in the cat

Airway acidification and gastroesophageal reflux

“…Therefore, when studying the links between acid reflux and respiratory disease, the appropriate study group is patients who have airway acidification associated with gastroesophageal reflux, a group now easily identifiable with EBC pH testing. Microliter quantities of stomach acid entering the airway are sufficient to cause a log order greater increase in respiratory resistance than milliliters of acid placed in the esophagus, reflecting the extreme sensitivity of the airway to acid insult compared with the esophagus [18,35,36]. Indeed, such data have suggested that esophageal pH-monitoring techniques for acid reflux simply may not be sensitive enough to detect the tiny amounts of aspirated acid that may cause airway acidification and respiratory dysfunction [37].…”

Update on gastroesophageal reflux disease and asthma in children

“…In a dog model, exposure of the laryngeal mucosa to a hydrochloric acid and pepsin mixture resulted in laryngeal dysfunction causing impairment in airway patency [10]. Overall, acid in the airway is more likely to cause bronchoconstriction than is acid in the esophagus [11,12].…”

Gastroesophageal reflux disease and asthma in children

“…During an episode of reflux, in addition to acid, pepsin-a proteolytic enzyme-may gain entry into the airway and is likely to cause lung injury. Overall, acid in the airway has a greater likelihood to cause bronchoconstriction than acid in the esophagus [7,8].…”