P0981 GASTROESOPHAGEAL REFLUX IN CHILDREN WITH PERSISTENT ASTHMA: CORRELATION WITH PULMONARY FUNCTION TEST

Abstract

Introduction: The relationship of cause and effect between gastroesophageal reflux (GER) and asthma is not well known. Recent studies have shown high prevalence of GER in children with asthma; however, with different results of correlation with pulmonary function. This study aimed to evaluate the prevalence of GER in children with persistent asthma and to compare the symptoms of GER, intraesophageal pH studies and pulmonary function tests in children with and without GER. Methods: Thirty eight patients from 5 to 15 years of age were evaluated. All patients had diagnosis of asthma according to NIH guidelines,19971 and were chronically using medicatons for asthma control such as inhalated corticosteroids or leucotriens. Prolonged intraesophageal pH-study (Digitrapper MKIII, Synetics, Sweden) and espirometry (Jaeger Flow Pro, Erich Jaeger GmbH, Germany) were performed in all patients. Positive pH-study for GER was defined as total reflux index (RI) more than 5%. Pulmonary function was evaluated by measuring FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 second) and FEF25–75% (midexpiratory flow rate). Results: Median (range) age was 10 (5–15) years old and 23 (59%) patients were male. Prevalence of GER was 47.3%. The patients were divided in 2 groups according to pH-study: group I-asthma and GER (n=18); group II-asthma without GER (n=20). There was no significant difference of gastrointestinal symptoms such as vomiting and abdominal pain between groups I and II. Fifty percent of patients from group I did not have any symptom of GER. Regarding the results of pulmonary function tests, only FEF25–75% was <75% of predicted value without significant difference (group I: 66.8%, group II 56.8%, p: 0.34). From all patients, the coefficient of correlation between RI and CVF was r: −0.17 (p 0.28); RI and VEF1 was r:–0.17 (p 0.29), and RI and FEF 25–75 was r:–0.10 (p 0.54). Conclusion: Gastroesophageal reflux had high prevalence among children with persistent asthma; however, without significant correlation between alterations of pH-study and pulmonary function test. GER might be considered in pediatric patients with persistent asthma, even in the absence of gastrointestinal symptoms.