[Gastroesophageal reflux and bronchial asthma]

Area of Science:

• Gastroenterology
• Pulmonology
• Allergology

Background:

• Gastroesophageal reflux (GER) is a condition where stomach acid flows back into the esophagus.
• Bronchial asthma is a chronic respiratory disease characterized by inflammation and narrowing of the airways.
• The relationship between GER and bronchial asthma requires further investigation.

Purpose of the Study:

• To investigate the prevalence and mechanisms of gastroesophageal reflux in patients with allergic bronchial asthma.
• To explore the role of esophageal sphincter function in the development of GER in asthma patients.
• To evaluate the potential therapeutic benefits of addressing GER in managing bronchial asthma.

Main Methods:

• Intraesophageal pH-metry was used to assess acid reflux.
• Electromanometry was employed to measure the tone of the upper and lower esophageal sphincters.
• Prospective observational studies were conducted over an 8-year period.

Main Results:

• Gastroesophageal reflux was identified in 12 of 38 patients with allergic bronchial asthma.
• Significant GER was detected in half of the cases via pH-metry.
• Bronchial asthma developed in 9 of 63 patients with initial GER but no prior lung issues.
• Reduced lower esophageal sphincter tone was the primary mechanism for GER in asthma patients.
• Lowered upper esophageal sphincter tone in asthma patients with GER led to microaspiration.

Conclusions:

• Diminished lower esophageal sphincter tone is a key factor in GER development among bronchial asthma patients.
• Lowered upper esophageal sphincter tone contributes to microaspiration of gastric contents in these patients.
• Metoclopramide may be beneficial in treating patients with co-existing bronchial asthma and GER by increasing esophageal sphincter tone.