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Gastroesophageal reflux: a potential asthma trigger.

Susan M Harding1

  • 1Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, 1900 University Blvd, THT Rm 215, Birmingham, AL 35294, USA. sharding@uab.edu

Immunology and Allergy Clinics of North America
|December 8, 2004
PubMed
Summary

Gastroesophageal reflux (GER) can trigger asthma symptoms in many patients. Treating GER with acid-reducing medication can significantly improve asthma control and reduce exacerbations.

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Area of Science:

  • Pulmonology and Gastroenterology
  • Investigates the intricate relationship between respiratory and digestive system disorders.

Background:

  • Gastroesophageal reflux (GER) is identified as a significant potential trigger for asthma development and exacerbations.
  • A high prevalence of hiatal hernia and autonomic dysregulation in asthmatics may predispose them to GER.
  • Certain asthma medications might exacerbate GER, creating a complex interplay between the conditions.

Purpose of the Study:

  • To explore the link between GER and asthma, identifying GER as a risk factor for asthma-related hospitalizations and oral steroid use.
  • To elucidate the mechanisms by which esophageal acid may induce bronchoconstriction, including vagal reflexes and neurogenic inflammation.
  • To evaluate the efficacy of anti-reflux therapy in improving asthma symptoms in patients with co-existing GER.

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Main Methods:

  • Observational analysis of asthmatics reporting heartburn, a common GER symptom.
  • Assessment of GER as a risk factor for asthma exacerbations and medication use.
  • Evaluation of a 3-month empirical trial of twice-daily proton pump inhibitor (PPI) therapy for identifying GER as an asthma trigger.

Main Results:

  • Approximately 77% of asthma patients report experiencing heartburn, suggesting a high comorbidity.
  • Anti-reflux therapy demonstrated significant improvement in asthma symptoms for about 70% of asthmatics with GER.
  • Empiric PPI treatment effectively identifies asthmatics for whom GER is a primary asthma trigger.

Conclusions:

  • GER is a prevalent and significant factor contributing to asthma symptoms and exacerbations.
  • Targeted anti-reflux therapy, particularly with proton pump inhibitors, offers a viable treatment strategy for improving asthma control in a majority of affected patients.
  • Empirical PPI trials are recommended for identifying GER as a modifiable trigger in asthma management.