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Oesophageal reflux and asthma

J G Ayres1, J F Miles

  • 1Birmingham Heartlands Hospital, Bordesley Green East, UK.

The European Respiratory Journal
|May 1, 1996
PubMed
Summary

Asthma and gastro-oesophageal reflux (GER) frequently coexist. Treating severe GER may improve asthma symptoms, but surgery is a last resort for reflux, not asthma control.

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Area of Science:

  • Pulmonology
  • Gastroenterology
  • Clinical Medicine

Background:

  • Asthma and gastro-oesophageal reflux (GER) are commonly comorbid conditions.
  • The relationship between asthma and GER can be bidirectional and complex.
  • GER can exacerbate asthma via aspiration or vagal reflexes; asthma can worsen GER through medications and hyperinflation.

Purpose of the Study:

  • To explore the intricate relationship between asthma and GER.
  • To understand the mechanisms by which GER affects asthma and vice versa.
  • To evaluate the impact of GER treatment on asthma control.

Main Methods:

  • Review of existing literature on asthma and GER.
  • Analysis of proposed pathophysiological mechanisms.
  • Anecdotal evidence and clinical observations regarding treatment outcomes.

Main Results:

  • Gastric acid aspiration into the trachea can reduce lung function in some asthma patients.
  • Acid reflux in the lower esophagus can trigger asthma exacerbations through vagal reflexes.
  • Asthma medications and lung hyperinflation can negatively impact lower esophageal sphincter pressure, worsening GER.

Conclusions:

  • The association between asthma and GER is multifactorial.
  • Treatment of GER may benefit some individuals with asthma, especially those with severe reflux.
  • GER surgery should prioritize symptom improvement and be considered only after medical treatment failure.

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