Gastroesophageal reflux in children with refractory asthma
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Updated: May 28, 2026
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Alaa S Deeb1, Amal Al-Hakeem, Ghazal S Dib
1Department of Pediatrics, Tishreen University, Syrian Arab Republic.
Insights
Gastroesophageal reflux (GER) is more common in children with refractory asthma, though its symptoms and endoscopic findings do not correlate with asthma severity. Reflux esophagitis, however, showed a significant association with asthma severity.
Area of Science:
- Pediatric Pulmonology
- Gastroenterology
- Asthma Research
Background:
- Refractory asthma significantly impacts children's quality of life.
- Gastroesophageal reflux (GER) is a potential comorbidity in asthma patients.
- Understanding the link between GER and asthma severity is crucial for effective management.
Purpose of the Study:
- To investigate the association between GER findings and refractory asthma severity.
- To evaluate clinical and macroscopic findings of GER in children with refractory asthma.
- To determine if GER symptoms or endoscopic findings correlate with asthma severity.
Main Methods:
- Prospective study of 75 children with refractory asthma.
- Inclusion of medical history, physical examination, spirometry, and skin prick tests.
- Performance of endoscopic and macroscopic evaluations for esophagitis in all participants.
Main Results:
- GER symptoms were present in 65% of patients, with abdominal pain being most frequent.
- Macroscopic esophagitis was observed in 71% of children.
- While GER symptoms did not correlate with asthma severity, reflux esophagitis showed a statistically significant association (p<0.05).
- Endoscopic reflux was significantly more frequent in non-allergic patients (76.3%, p<0.05).
Conclusions:
- GER is more frequent in children with refractory asthma compared to the general pediatric population.
- No significant relationship was found between asthma severity and GER symptoms or endoscopic findings.
- Reflux esophagitis, however, demonstrated a statistically significant link to asthma severity.
Objectives:
To investigate the association between clinical and macroscopic findings of GER and severity of refractory asthma (statistical study).
Methods:
A prospective study in a university-based practice of 75 children who were diagnosed with refractory asthma because they exhibited no satisfactory response for at least three months of treatment. Medical history, physical examination, spirometrical measurements and prick skin test were conducted on all patients. Endoscopic and macroscopic evaluations for esophagitis were performed on all patients regardless of the presence of GER symptoms.
Results:
Endoscopy was done for 75 children with refractory asthma. GER was symptomatic in 65% of all patients with no statistical significance (p>0.05) and the most frequent symptom was abdominal pain (67%). The frequency of these symptoms was 50% in mild asthma, 58% in moderate asthma and 72% in severe asthma with no statistical significance (p>0.05). The frequency of macroscopic esophagitis was 71%, distributed in three asthmatic groups as in order of 75% in mild asthma, 58.3% in moderate asthma and 76.6% in severe asthma (p>0.05). Regarding the relationship between GER and nocturnal attacks or spasmodic cough, the frequency of the latest was 66.7%. The differences have no statistical significance regarding GER symptoms (p>0.05), but they are statistically significant regarding the reflux esophagitis (p<0.05). Also endoscopic reflux was as frequent as76.3% in non allergic patients, and this result is statistically significant (p<0.05).
Conclusion:
In spite of the fact that there was no relationship between the severity of asthma and the symptoms of GER, or its endoscopic findings, the frequency of GER in asthmatic children was higher than its frequency in other children.
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