Treatment of gastro‐oesophageal disease in patients with asthma

Abstract

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).