Abstract
Background: Nowadays it is considered that a specific causal relationship exists between asthma and gastroesophageal reflux (GER), because of the aspiration of gastric refluate which leads to and maintain spasticity even real crisis of paroxystic expiratory dyspnea. This study explores this relationship and evaluates the results after treatment. Methods: 56 children diagnosed with asthma, hospitalized in a regional center of pediatric gastroenterology in Northeast Romania, underwent 24-hour continuous esophageal pH monitoring in order to establish the presence of GER. The Boix-Ochoa score was used to interpret the results. Proton pump inhibitors were administered to those with GER and the patients were reevaluated after 2 months. Results: 39 patients (69.64%) had GER, with a Boix-Ochoa score above normal (N < 11.99), and 17 patients (30.36%) had normal score. After administering proton pump inhibitors for 2 months, 7 patients still had high Boix-Ochoa score (17.95%). The result of this analysis shows that the presence of asthma increases the chance of GER by 2.86 times. Conclusions: In children with asthma we have to look for GER in order to treat, because it can help the treatment of asthma or even solve some cases resistant to standard treatment.
Highlights
The American College of Gastroenterology guidelines define gastroesophageal reflux disease (GERD) as “symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus” [3]
In a study that investigated the prevalence of symptomatic gastroesophageal reflux (GER) in asthmatics based on a questionnaire, 77% of the 109 participants in the study suffered from epigastralgia, and 55% experienced regurgitation
Asthma is a strong reason for the evaluation of the presence of gastroesophageal reflux by using continuous esophageal pH-metry for 24 h, especially when there is a weak response to asthma therapy
Summary
Epidemiological studies have shown that there is a close connection between gastroesophageal reflux and asthma, especially in children [1,2]. The American College of Gastroenterology guidelines define gastroesophageal reflux disease (GERD) as “symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus” [3]. Asthma is a chronic disease of the airways which is characterized by obstructed airflow, bronchial hyperactivity, and inflammation [4]. Different comorbidities can accentuate symptoms or favor the emergence of asthma. In a study that investigated the prevalence of symptomatic gastroesophageal reflux (GER) in asthmatics based on a questionnaire, 77% of the 109 participants in the study suffered from epigastralgia, and 55% experienced regurgitation. Symptoms were more pronounced than in the control group [5]. GER can present with a variety of symptoms, ranging from digestive to respiratory and neurobehavioral [6]
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