Many patients with cystic fibrosis receive gastric acid inhibition with proton pump inhibitors, or histamine-2 receptor antagonists, to either increase the efficacy of pancreatic enzyme replacement therapy or for gastroesophageal reflux disease.
In this issue of The Journal, van der Doef et al from the University Medical Center in Utrecht have studied whether patients on gastric acid inhibition have increased risk of bacterial colonization or an altered rate of decline in pulmonary function. There were no significant differences in the group who received gastric acid inhibition for fat malabsorption, but the group with gastroesophageal reflux disease had earlier acquisition of P aeruginosa and S aureus and significantly reduced pulmonary function tests at 10 years old.
These data suggest that gastroesophageal reflux disease should be energetically pursued and treated in people affected by cystic fibrosis.
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