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Effect of intraesophageal acid instillation on airway reactivity in patients with asthma
V Singh1, V Aggarwal, S Bansal
1Pulmonary Medicine Division, SMS Medical College, Jaipur, India.
Objective:
To study the change in airway reactivity due to presence of acid in lower esophagus and its reversibility by antacid.
Method:
In this double blind study 12 subjects with asthma and gastroesophageal reflux received acid (N/10 hydrochloric acid) and antacid (mixture of magnesium trisilicate and aluminum hydroxide) perfusion in lower esophagus via a nasogastric tube. The four combinations were antacid-antacid (control), antacid-acid, acid-antacid and acid-acid. Airway reactivity (Histamine PD20) was recorded after each perfusion.
Results:
Histamine PD20 significantly decreased (airway reactivity increased) (p < 0.05) with all three combinations containing acid as compared to control. No significant difference in airway reactivity was observed if the antacid was given before or after the acid.
Conclusion:
Presence of acid in lower esophagus can increase airway reactivity. This effect lasts longer than the presence of acid in esophagus itself.
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