Gastroesophageal reflux disease and asthma. Diagnosis and management

Abstract

Gastroesophageal reflux is common among asthmatics. It not only may worsen during an episode of airways obstruction but also may serve as a trigger for such an attack. Both animal and clinical data suggest that gastroesophageal reflux serves as a trigger of bronchospasm, potentiates the bronchomotor response to additional triggers, or both. Patients with reflux-associated asthma may manifest symptoms of gastroesophageal reflux, either classic or atypical, but approximately 25% to 30% have clinically silent reflux. Despite the use of inadequate doses of acid-suppressive medicines, clinical trials have documented improvement in respiratory symptoms among asthmatics following the treatment of reflux. Recent trials suggest long-term improvement in respiratory symptoms following antireflux surgery. Selected patients with asthma should be evaluated for gastroesophageal reflux. If it is present, such patients may benefit from aggressive antireflux therapy.