Gastroesophageal Reflux Disease and Asthma

Abstract

Gastroesophageal reflux is common among asthmatics. It not only may worsen during an episode of airways obstruction but also may serve as a trigger for such an attack. Both animal and clinical data suggest that gastroesophageal reflux serves as a trigger of bronchospasm, potentiates the bronchomotor response to additional triggers, or both. Patients with reflux-associated asthma may manifest symptoms of gastroesophageal reflux, either classic or atypical, but approximately 25% to 30% have clinically silent reflux. Despite the use of inadequate doses of acid-suppressive medicines, clinical trials have documented improvement in respiratory symptoms among asthmatics following the treatment of reflux. Recent trials suggest long-term improvement in respiratory symptoms following antireflux surgery. Selected patients with asthma should be evaluated for gastroesophageal reflux. If it is present, such patients may benefit from aggressive antireflux therapy.

Difficult asthma

“…Gastroesophageal reflux (GER) is common in patients with asthma, with an estimated prevalence of 34-80% (24,25), vs. 5-10% in the general population (26). This large variation in GER prevalence reflects substantial differences in the standards applied for establishing the diagnosis of both asthma and GER and the frequency of silent GER (27).…”

Efficacy of Esomeprazole for Treatment of Poorly Controlled Asthma

“…Persons with asthma are particularly prone to asymptomatic GER. Esophageal pH probe studies have documented that 32–84% of asthmatics have abnormal acid reflux 1, 2, 3, 4, 5. About half of asthma patients who have reflux have no symptoms.…”

Doença do refluxo gastroesofágico: revisão ampliada

“…Contudo, as poucas revisões sistemáticas publicadas apresentam resultados confl itantes (7,14,18,33,41) . Estudo baseado em revisão sistemática de literatura (15) , avaliando a efi cácia do tratamento cirúrgico do refl uxo no controle da asma, conclui que: "o tratamento cirúrgico do refl uxo melhora os sintomas do refl uxo e da asma e reduzem a necessidade de medicamentos, mas tem pouco ou nenhum efeito sobre a função pulmonar".…”