Pharmacological and surgical interventions for the treatment of gastro-oesophageal reflux in adults and children with asthma

Kopsaftis, Zoe; Yap, Hooi Shan; Tin, Kyi Saw; Hnin, Khin; Carson‐Chahhoud, Kristin

doi:10.1002/14651858.cd001496.pub2

Cited by 9 publications

(7 citation statements)

References 100 publications

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“…Of even greater clinical significance is the use of ASMs in children with NI. The period prevalence of treatment with ASMs that we found is dramatically higher than the general paediatric population (23.7% vs 0.3%–1.3%) and more comparable to that of adult populations (15%–33%) 3 32–36. We also found evidence of prolonged or recurrent treatment courses.…”

Section: Discussionsupporting

confidence: 47%

Gastro-oesophageal reflux disease in children with neurological impairment: a retrospective cohort study

Dewan

Turner

Lethebe

et al. 2022

bmjpo

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ObjectivesTo determine the incidence and prevalence of gastro-oesophageal reflux disease (GERD) diagnosis and treatment in children with neurological impairment (NI) along with relationship to key variables.DesignThis is a population-based retrospective cohort study.SettingThis study takes place in Alberta, Canada.PatientsChildren with NI were identified by hospital-based International Classification of Diseases (ICD) codes from 2006 to 2018.Main outcome measuresIncidence and prevalence of a GERD diagnosis identified by: (1) hospital-based ICD-10 codes; (2) specialist claims; (3) dispensation of acid-suppressing medication (ASM). Age, gender, complex chronic conditions (CCC) and technology assistance were covariates.ResultsAmong 10 309 children with NI, 2772 (26.9%) met the GERD definition. The unadjusted incidence rate was 52.1 per 1000 person-years (50.2–54.1). Increasing numbers of CCCs were associated with a higher risk of GERD. The HR for GERD associated with a gastrostomy tube was 4.56 (95% CI 4.15 to 5.00). Overall, 2486 (24.1%) of the children were treated with ASMs of which 1535 (61.7%) met no other GERD criteria. The incidence rate was 16.9 dispensations per year (95% CI 16.73 to 17.07). The prevalence of gastrojejunostomy tubes was 1.1% (n=121), surgical jejunostomy tubes was 0.7% (n=79) and fundoplication was 3.4% (n=351).ConclusionsThe incidence of GERD in children with NI greatly exceeds that of the general paediatric population. Similarly, incidence rate of medication dispensations was closer to the rates seen in adults particularly in children with multiple CCCs and gastrostomy tubes. Further research is needed to determine the appropriate use of ASMs balancing the potential for adverse effects in this population.

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Section: Discussionsupporting

confidence: 47%

Gastro-oesophageal reflux disease in children with neurological impairment: a retrospective cohort study

Dewan

Turner

Lethebe

et al. 2022

bmjpo

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“…Clinical trials of proton pump inhibitors in patients with confirmed asthma, most of whom had a diagnosis of GERD, showed small benefits for lung function, but no significant benefit for other asthma outcomes. 473,474 In a study of adult patients with symptomatic asthma but without symptoms of GERD, treatment with high dose proton pump inhibitors did not reduce asthma symptoms or exacerbations. 475 In general, benefits of proton pump inhibitors in asthma appear to be limited to patients with both symptomatic reflux and night-time respiratory symptoms.…”

Section: Managementmentioning

confidence: 99%

“…In summary, symptomatic reflux should be treated, but patients with poorly controlled asthma should not be treated with anti-reflux therapy unless they also have symptomatic reflux (Evidence A). 474 Few data are available for children with asthma symptoms and symptoms of GERD. 477,478…”

Section: Managementmentioning

confidence: 99%

Peak Flow and Mini-spirometry in the Diagnosis of Obstructive Airway Diseases

Padmanabhan¹,

Nair²,

Babu³

et al. 2023

HAP

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Background: India is initiating measures to address Chronic Obstructive Pulmonary Disease(COPD) and Asthma, major causes of mortality and morbidity, at the primary care level. The efforts are limited by the lack of access to spirometry. Various alternatives are being tried out in resource limited countries. Methods: A hospital based cross-sectional study was done at two tertiary care hospitals in Trivandrum, South India, in patients with a clinical diagnosis of COPD or Asthma. Spirometry was done by a trained spirometry technician, along with peak-flow recording and a recording on portable mini-spirometer (COPD6 ®). The values obtained by the latter two were compared to those obtained by spirometry. Results: The study included 360 patients. PEFR showed a positive correlation with both FEV1/FVC as well as FEV1 (R2 of 0.35 and 0.65, respectively). FEV1/FEV6 and FEV1 on COPD6 also correlated positivity with FEV1 and FEV1/FVC on spirometry (R2 of 0.68 and 0.89, respectively). Sensitivity and specificity of PEFR to diagnose obstruction was best at a cut-off of 74% of predicted, as determined by ROC, giving sensitivity of 84.8% and specificity of 85.1%. Sensitivity and specificity of COPD6 to detect obstruction was 75.9% and 95.7%, respectively. Conclusion: Mini-spirometry (COPD6) and peak-flow measurement may be used as alternatives to spirometry in resource limited settings as in the primary care centers of India for the diagnosis of obstructive airway diseases.

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“…(see http://www.cochranelibrary.com for information). Cochrane reviews are regularly updated as new evidence emerges and in response to feedback, and the Cochrane Library should be consulted for the most recent version of the review 7 …”

Section: Disclaimermentioning

confidence: 99%

Treatment of gastro‐oesophageal disease in patients with asthma

Dale

Adesina

2023

Clin Experimental Allergy

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Asthma and gastro-oesophageal reflux disease (GORD) are both common medical conditions. Globally, asthma affected 262.4 million people in 2019 1 and is the most common chronic disease in children. 2 In comparison with the general population, the prevalence of GORD is reported to be increased in people with asthma; 3 however, the mechanism underpinning this relationship remains unclear. 3 The presence of GORD in people with asthma is associated with increased exacerbations and lower quality of life scores 4 and is, therefore, an important and potentially modifiable factor.Gastro-oesophageal reflux disease can be treated pharmacologically and surgically alongside lifestyle adjustments. A 4-week trial of a proton pump inhibitor (PPI) is considered the first line pharmacological management in adults. 5 A histamine receptor (type 2) antagonist (H 2 RA) is considered interchangeably with a PPI in children or young people (CYP) 6 and as second line in adults, 5 prokinetics can also be considered in certain circumstances. 5,6 Surgical options include a Nissen fundoplication and partial posterior semi-fundoplication (Toupet and Lind techniques).

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Pharmacological and surgical interventions for the treatment of gastro-oesophageal reflux in adults and children with asthma

Cited by 9 publications

References 100 publications

Gastro-oesophageal reflux disease in children with neurological impairment: a retrospective cohort study

Gastro-oesophageal reflux disease in children with neurological impairment: a retrospective cohort study

Peak Flow and Mini-spirometry in the Diagnosis of Obstructive Airway Diseases

Treatment of gastro‐oesophageal disease in patients with asthma

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