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Gastroesophageal reflux disease and asthma: an intriguing dilemma
C Astarita1, D Gargano, M Cutajar
1Dipartimento di Internistica Clinica e Sperimentale F. Magrassi, Clinica Medicina Seconda Università di Napoli, Naples, Italy.
Background:
Gastroesophageal reflux disease (GORD) is characterized by typical reflux symptoms and multiple atypical extraesophageal symptoms. Gastric asthma is a prominent extraesophageal manifestation of GORD. There is persistent debate about the pathophysiologic mechanisms triggering asthma by GOR.
Methods:
We conducted a review of the literature.
Results:
The pathogenic mechanism could be either a vagally transmitted reflex or an intratracheal aspiration of refluxed material. In both hypotheses, the role of inflammatory mediators has been proposed.
Conclusions:
Neurogenic inflammation is a good theoretic basis for a pathogenic interpretation of the disorder. In atopic patients, food allergy has been recently proposed as a possible cause of GOR and associated respiratory symptoms, and it should be considered in the diagnostic work-up of all patients with GORD.