Esophageal Inlet Patch: A Clinically Significant Entity in Advanced Pulmonary Disease and Lung Transplant Rejection

Background: Esophageal inlet patch (IP) refers to heterotopic gastric mucosa in the cervical esophagus. Secretions from IP may produce symptoms of laryngopharyngeal reflux (LPR) and accelerate progression lung disease. We aimed characterize significance among patients with advanced pulmonary disease, including transplant (LTx) recipients, assess outcomes following ablation. Methods: established reviewed a prospective database all disease referred for GI motility evaluation presence over 7 years. Total size, results pH testing, incidence rejection mortality, effects ablation on were analyzed. Results: Twenty-seven (13 LTx recipients) 440 upper endoscopy found have IPs, 14 completed (mean number 1.7 sessions ablate IP). size correlated total acid exposure time ( P = .01) cough < .00001), heartburn .0001), globus .00001). Symptom severity dysphagia improved .04 0.008). Eight 13 patient developed either acute or chronic rejection, 3 cases post-LTx mortality occurring who did not undergo Conclusions: should be given careful consideration particularly if cough, heartburn, are present. predictive LPR, symptom recurrence prompt re-examination residual IP.