Efeito da acidificação esofágica na obstrução brônquica de pacientes asmáticos com refluxo gastroesofágico

Abstract

Background: The relationship between asthma and gastroesophageal reflux is, as yet, not completely understood. Among the mechanisms thought to be responsible for gastroesophageal reflux-related worsening of asthma symptoms are the vagovagal reflex and microaspiration.Objective: To assess forced expiratory volume in one second after acid infusion.Method: This study investigated the effect of acid infusion in 13 volunteers with moderate asthma and gastroesophageal reflux. Spirometry was performed before and after insertion of an 8F nasogastric tube and a pH meter. After 15 minutes of saline solution infusion into the midpoint between the upper esophageal sphincter and lower esophageal sphincter, and again after 15 minutes of esophageal acidification (with hydrochloric acid) of the same area, forced expiratory volume in one second was reassessed. Acidification was repeated every 5 minutes until forced expiratory volume in one second values stabilized (variation: < 5%).Results: Mean forced expiratory volume in one second values remained stable during the tube insertion, saline infusion, initial hydrochloric acid infusion and subsequent hydrochloric acid infusion procedures (p = 0.72). Lower forced expiratory volume in one second values were seen resulting from the tube insertion in two patients (drops of 11% and 22%, respectively), after saline infusion in another two (drops of 13% and 14%) and after acid infusion in 1 (a drop of 22%). Conclusion:Esophageal acidification over short periods does not lead to spirometric alterations in a group of asthmatics with gastroesophageal reflux. However, in some cases, simple esophageal procedures or infusions result in bronchospasm.

Tratamento Da Doença Do Refluxo Gastroesofágico Para O Controle Da Asma Infantil

“…Como resultado, verificou-se que dois pacientes apresentaram queda maior que 10% no volume expiratório forçado no primeiro segundo após a sondagem esofágica e outros dois apresentaram a redução após a infusão de solução salina e queda ainda maior após a infusão ácida. Entretanto, outros onze indivíduos não apresentaram alterações do volume expiratório forçado no primeiro segundo após a infusão do ácido (Araujo et al, 2005).…”

Asma e refluxo gastroesofágico

“…(6) It is possible that in asthma patients there is more than one mechanism involved in the correlation between reflux and asthma. Other authors (7) studied the effect of acid infusion into the stomachs of 13 volunteers with stable moderate asthma and GERD. They noted that two patients presented a more than 10% decrease in forced expiratory volume in one second after esophageal tube insertion.…”