Association of gastro esophageal reflex with chronic asthma and its significance: a prospective study
DOI:
https://doi.org/10.18203/2349-3291.ijcp20173795Keywords:
Chronic asthma, Gastro esophageal reflex, Prospective studyAbstract
Background: Many studies have reported that gastro esophageal reflux is significantly more common in asthmatics than in control populations and this appears to apply particularly in childhood. To study the incidence of gastro esophageal refluxes in children which chronic asthma. To identity the clinical characteristic in children with chronic asthma and GER, which would predict reflux, related asthma?
Methods: It is a prospective study of association of GER and chronic asthma using Radio nuclide scintigraphy carried at General pediatric in-patient wards of Niloufer hospital, Hyderabad. A Total of 50 patients with chronic asthma and 15 healthy children were evaluated.
Results: Our study showed an incidence of Gastro Esophageal Reflux (GER) in 42% of chronic asthmatic children. High incidence of reflux (47.6%) under 4 years of age. No significance difference in the incidence of GER in children with seasonal verus Non-Seasonal asthma. About 50% of children with GER had no symptoms i.e. they had silent reflux. Nocturnal symptoms were significantly higher in asthmatic children with Ger (54.8%) than asthmatic children without GER (21%). Children with reflux related asthma suffered more morbidity in terms of recurrence of attacks, severity of chronic asthma (moderate persistent) and sleep disturbance as compared to children with no reflux. Presence of atopic signs was significantly higher in patients with asthma without GER.
Conclusions: GER should be considered as a potentially important contributing factor in any patient with poorly controlled asthma. The asthmatic patient most likely to experience measurable benefit from anti-reflux therapy is the patients with significant nocturnal asthma and who have symptoms of both asthma and of reflux.
References
Christie DL, O’ Grady LR, Macek DV. Incompetent lower esophageal sphincter and GER in recurrent acute pulmonary disease of infancy and childhood. J Pediatr. 1978;93:23-7.
Berqist WE, Racheles fsky GS, Kadden M, et al. GER-associated recurrent pneumonia and chronic asthma in children. Pediatr. 1981;68:29-35.
Wong RK, Maydononvituch C, Garcia JE. The effect of terbutalin sulphate, aminophylline on LES pressure and radio-nuclide esophageal empting in patients with achalesia. J Clin Gastroenterol. 1987;9:386-9.
Hubert D, Gauderic, M, Guerr J. Effect of theophylline on GER in patients with asthma. J Allergy Child Immunol. 1988;81:1168-74.
Ekstorm T, Tibbling L. Influence theophylline on GER and asthma. Eur J Clin Pharma 1988;35:353-6.
Kashyap R, Sharma R, Madan N. Evaluation of Radionuclide gastro esophagography as a suitable screening test for detection of GER. Indian Pediatr. 1993;30(5):625-8.
Chopra K, Matta SK, Madan N. Association of GER with Bronchial asthma. Indian Pediatr. 1995; 32(10):1083-6.
Sontag SJ, Schnell JG, Miller TQ. Prevalence of esophagitis in asthmatics. GUT. 1992;33:872-6.
Dal Negro R. Prevalence of GER in asthmatics; an Italian study. Italian J Gastroenterol Hepatol. 1999;31:371-5.
Ruth M, Carlssons S, Mansson I. Scintigraphic detection of gastro pulmonary aspiration in patients with respiratory disorders. Clin Physiol. 1993;13:19-33.
Klauser AG, Schindlbeck NE, Muller-Lissner SA. Symptoms in GER. Lancet. 1990;335(8683):205-8.
Hughes DM, Spier S, Rivlin J. Gastroesophageal reflux during sleep in asthmatic patients. J Pediatr. 1983;102(5):666-72.
