PWE-110 Gastro-oesophageal reflux in cystic fibrosis: exploring the impact on lung disease

Introduction Studies have shown large amounts of gastro-oesophageal reflux (GOR) in CF patients, which frequently has characteristics which may favour aspiration - asymptomatic, proximal oesophageal extent and supine. Exposure to refluxate may worsen CF lung disease, as it contains acid, digestive enzymes and microbes, which can include respiratory pathogens. We aim to establish if there is a relationship between GOR and CF lung disease. Method We are conducting a prospective observational study in stable CF patients, measuring oesophageal reflux with combined pH and impedance (pH-MII) and reflux symptoms using the RESQ-7 questionnaire. In a preliminary analysis we have collected retrospective data from the medical records for lung function and number of courses of intravenous antibiotics. Results 21 of 30 recruited completed the study (mean age 28 years, mean FEV1 50% predicted, 19 males). Total number of reflux episodes was increased in 72% (median 89, IQR 68–132, normal range Interestingly, number of intravenous antibiotic treatments positively correlated with total reflux events (r=0.45, p=0.004) and suggested potential trends with high risk parameters (e.g. proximal reflux r=0.37, p=0.1). However there were no correlation between reflux parameters and spirometry. Conclusion CF patients have large amounts of ‘high-risk’ reflux, and our data suggests a potential relationship between reflux severity and the number of pulmonary exacerbations, represented by the requirement for intravenous antibiotics. To explore this further a reliable biomarker of aspiration, such as sputum pepsin, is required. Disclosure of Interest None Declared