Oral Corticosteroids Increase Esophageal Acid Contact Times in Patients With Stable Asthma

Lazenby, John P.; Guzzo, Melany R.; Harding, Susan M.; Patterson, Patricia; Johnson, Lawrence F.; Bradley, Laurence A.

doi:10.1378/chest.121.2.625

Cited by 79 publications

(40 citation statements)

References 34 publications

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“…It may be clearly determined when asthma patients have grade M of GERD; however, it has not been determined whether minimal change of grade M affects asthma symptoms and also whether treatment for minimal change of GERD improves asthma. There were reports that asthma medicine of corticosteroid, theophylline, or β 2-agonist had a possibility of inducing GERD (Stein et al 1980;Schindlbeck et al 1988;Lazenby et al 2002); however, it has not been determined whether these asthma medicines induce grade M of GERD. Further investigations are needed to evaluate the impact of minimal change of GERD on asthma.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Gastroesophageal Reflux Disease with Minimal Mucosal Change in Asthmatic Patients

Shimizu

Dobashi

Kobayashi³

et al. 2006

Tohoku J. Exp. Med.

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It is known that the prevalence of gastroesophageal reflux disease (GERD) in asthmatic patients is high. Although an endoscopic diagnosis of GERD based on the established Los Angeles (LA) classification requires the detection of erosive mucosal breaks, there are patients with GERD who have prominent erythema of the esophageal membrane without erosive mucosal breaks. Non-erosive mucosal change denotes the minimal change of the discoloring type of reflux esophagitis. This study was undertaken to determine the prevalence of GERD in asthmatic patients using the LA classification with the inclusion of minimal change, compared to the prevalence determined using the established LA classification without minimal change. The presence of GERD in asthmatic patients (n = 78), non-asthmatic disease control patients (n = 56), and healthy subjects (n = 150) was evaluated by endoscopic examination. The frequency of GERD in asthmatic patients based on the LA classification with minimal change was higher (54/78, 69.2%) than in asthmatic patients based on the LA classification without minimal change (37/78, 47.4%) ( p < 0.05). The prevalence of GERD in asthmatic patients (69.2%) was higher than that in disease control patients (17/56, 30.4%) and healthy subjects (27/150, 18.0%) based on the LA classification with minimum change. These data indicate that asthmatic patients have a high frequency of GERD. In addition, without the inclusion of minimum change to the diagnosis of GERD, the prevalence of GERD appears to be underestimated in asthmatic patients. Therefore, physicians should carefully observe asthmatic patients with minimal change on endoscopy.

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Section: Discussionmentioning

confidence: 99%

High Prevalence of Gastroesophageal Reflux Disease with Minimal Mucosal Change in Asthmatic Patients

Shimizu

Dobashi

Kobayashi³

et al. 2006

Tohoku J. Exp. Med.

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“…Patients may note the onset or worsening of gastroesophageal reflux after beginning oral corticosteroids. 28 As demonstrated in the present 2 cases, bronchodilator medication use without a clear indication is a potential, albeit unproven, explanation for increased gastroesophageal reflux and associated respiratory symptoms. Both of the present cases had a history of gastroesophageal reflux and/or increased gastroesophageal reflux symptoms following exposure-related treatment.…”

Section: Potential Treatment Errors and Consequencesmentioning

confidence: 69%

Can Reactive Airways Dysfunction Syndrome (RADS) Be Iatrogenic?

Hewitt¹

2011

Respir Care

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Reactive airways dysfunction syndrome (RADS) is an asthma-like illness that develops after a single high-level exposure to a pulmonary irritant. Two different cases are reviewed, in which the exposure circumstances were not sufficient to result in adverse health effects yet resulted in persistent respiratory symptoms and a clinical diagnosis of RADS. Potential explanations for an erroneous diagnosis of RADS included an incomplete exposure assessment, medication adverse effects that can contribute to respiratory symptoms, and alternative explanations for respiratory symptoms or test findings. In particular, the empirical use of bronchodilator medications without a clear indication appeared to contribute to continued respiratory symptoms. Without a clear understanding of the patient's exposure, a RADS diagnosis should be carefully considered. The possibility of an iatrogenic sequence of events in which medication adverse effects facilitate respiratory symptoms and a mistaken RADS diagnosis should be considered, particularly in patients who have a poorly defined exposure history.

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“…Nie bez znaczenia są również leki bronchodylatacyjne stosowane w leczeniu AO. Poza teofiliną o udowodnionym działaniu zwiększającym wydzielanie kwasu solnego oraz obniżającym napięcie dolnego zwieracza przełyku, która obecnie jest rzadziej stosowana, więk-szość leków przeciwastmatycznych może mieć mniejsze lub większe znaczenie w patogenezie choroby refluksowej u pacjentów z AO [16,17].…”

Section: Wstępunclassified

Influence of gastroesophageal reflux measured by pH-impedance on asthma control degree in children and youth

Szaflarska-Popławska¹,

Popławski²

2011

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Oral Corticosteroids Increase Esophageal Acid Contact Times in Patients With Stable Asthma

Cited by 79 publications

References 34 publications

High Prevalence of Gastroesophageal Reflux Disease with Minimal Mucosal Change in Asthmatic Patients

High Prevalence of Gastroesophageal Reflux Disease with Minimal Mucosal Change in Asthmatic Patients

Can Reactive Airways Dysfunction Syndrome (RADS) Be Iatrogenic?

Influence of gastroesophageal reflux measured by pH-impedance on asthma control degree in children and youth

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