Role of gastroesophageal reflux in older children with persistent asthma.
BACKGROUND: Gastroesophageal reflux ( GER) plays a role in inducing or exacerbating asthma. METHODS: We evaluated asthma outcome before and after anti- GER treatment in older children (age range, 5 to 10.5 years) who had persistent moderate asthma and were being treated with short- and long-acting bronchodilators, inhaled corticosteroids, and leukotriene antagonists. Forty-six such consecutive children underwent extended esophageal pH monitoring. Of the 27 patients (59%) who had evidence of GER disease, 18 patients underwent medical treatment (lifestyle changes, proton pump inhibitors, and prokinetics) and 9 patients opted for surgical treatment (Nissen fundoplication) of GER. Of the 19 patients with normal pH study findings, 8 patients underwent empiric medical anti- GER treatment and the remaining 11 patients served as a control group. Data on all patients were collected from 6 months prior to performing the pH studies and for 12 months after initiation of anti- GER treatment. The frequency of oral and inhaled corticosteroids, short- and long-acting bronchodilators, and leukotriene antagonists was prospectively recorded. RESULTS: There was a significant reduction in the use of short- and long-acting bronchodilators as well as inhaled corticosteroids after anti- GER treatment was instituted in patients with GER disease (p < 0.05). Two patients (25%) without evidence of GER disease showed significant reduction in need for asthma medication after anti- GER treatment, but none of the patients without GER disease and no GER treatment showed any significant reduction in the need for asthma medications. CONCLUSIONS: Anti- GER treatment in patients with GER disease and asthma results in a significant reduction in the requirement of asthma medications.[1]References
- Role of gastroesophageal reflux in older children with persistent asthma. Khoshoo, V., Le, T., Haydel, R.M., Landry, L., Nelson, C. Chest (2003) [Pubmed]
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