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Updated: Jun 8, 2025

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
A systematic review and meta-analysis exploring the bidirectional association between asthma and gastroesophageal
KaiWen Zheng1, Xiang Wang1, LinYan Tang1
1From the School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China and.
Insights
Asthma and gastroesophageal reflux disease (GERD) in children have a two-way link, with asthma increasing GERD risk more significantly. Further research is needed to confirm this association.
Area of Science:
- Pediatric Pulmonology
- Pediatric Gastroenterology
- Epidemiology
Background:
- Asthma is a leading chronic respiratory illness in children.
- Gastroesophageal reflux disease (GERD) is a recognized extraesophageal complication of pediatric asthma.
- The causal relationship between asthma and GERD in children remains under investigation.
Approach:
- A systematic review and meta-analysis were conducted to investigate the bidirectional association between asthma and GERD in pediatric populations.
- Original studies published between January 2000 and February 2024 were systematically searched and screened.
- Study quality was assessed using the Newcastle-Ottawa Scale, and relevant outcome measures were extracted.
Key Points:
- Nine eligible studies encompassing 304,399 children across seven countries were included in the analysis.
- Children with asthma exhibited a higher risk of developing GERD (OR 2.16) compared to children with GERD developing asthma (OR 1.55).
- The findings indicate a mutually aggravating relationship between asthma and GERD in children.
Conclusions:
- Asthma and GERD present a bidirectional association in children, acting as mutually aggravating factors.
- The risk of developing GERD is notably higher in children with asthma.
- High-quality, large-scale prospective cohort studies are recommended to further elucidate this relationship.
Abstract:
Background: Asthma is the most prevalent chronic respiratory disease in children, and gastroesophageal reflux disease (GERD) is one of its extraesophageal complications of asthma. Both conditions are commonly observed in pediatric outpatient clinics, but the causality between them in children is still debated. Therefore, we conducted a systematic review and meta-analysis to evaluate the bidirectional association between asthma and GERD in children. Methods: We systematically reviewed original studies published from January 2000 to February 2024 by searching the data bases. We also performed manual retrieval and screening to identify studies that met the inclusion criteria. The quality of the final included studies was evaluated by using the Newcastle-Ottawa Scale, and outcome measures were extracted. Results: We identified nine eligible studies, which included 304,399 children of different ages from seven countries. Overall, the risk of developing GERD in children with asthma (odds ratio [OR] 2.16 [95% confidence interval [CI], 1.6-2.91) was higher than the risk of developing asthma in children with GERD (OR 1.55 [95% CI, 1.32-1.82]). Conclusion: Based on the available studies, it can be concluded that asthma and GERD are mutually aggravating factors in children, presenting a bidirectional association. However, the risk of developing GERD in children with asthma is higher to some extent. More large-scale and high-quality prospective cohort studies are needed in the future to provide richer evidence and more research opportunities.
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