• Rasoul Aliannejad, Seyed-Mehdi Hashemi-Bajgani, Asharaf Karbasi, Mahvash Jafari, Jafar Aslani, Maryam Salehi, and Mostafa Ghanei.
• Respiratory Diseases and TB Research Center of Guilan University of Medical Science, Razi Hospital, Rasht, Iran.
• J Res Med Sci. 2012 Aug 1; 17 (8): 777781777-81.

Background And AimBronchiolitis obliterans (BO) is the main pulmonary involvement resulting from sulfur mustard (SM) gas exposure that was used against Iranian civilians and military forces during the Iran-Iraq war. The present study aimed to investigate the prevalence of gastro-esophageal reflux (GER) and gastric micro-aspiration in SM gas injured patients with chronic pulmonary diseases and recurrent episodes of exacerbations.Materials And MethodsThis cross-sectional study was done at Baqiyatallah University of Medical Sciences, Tehran, Iran. Gastric micro-aspiration and GER were assessed in the enrolled patients by assessing bile acids, pepsin and trypsin in their bronchoalveolar lavage fluid.ResultsOur result showed that bile acids were found to be high in 21.4% patients, and low in 53.6% of patients. Only in 16% patients, no bile was detected in the BALF. Trypsin and pepsin were detected in BAL fluid of all patients.ConclusionMost of BO patients after exposure to SM suffer GER, while none the etiologic factors of GER in post lung transplant BO are present. It would be hypothesized that GER per se could be considered as an aggregative factor for exacerbations in patients. Further studies will provide more advances to better understanding of pathophysiological mechanism regarding GER and BO and treatment.

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