Surgical treatment of gastroesophageal reflux in ten patients with severe asthma.
The surgical cure of gastroesophageal reflux was investigated in 10 asthmatic adults with a mean post-operative follow-up period of 21 months. The patients had severe asthma, and gastroesophageal reflux confirmed by 3-hour post-prandial pH monitoring. Medical treatment for reflux was effective on the clinical signs of the reflux but ineffective on the respiratory signs. The clinical course of the asthma, and 3-hour post-prandial pH monitoring were evaluated before 3, 6, and after 6 months. The reflux was cured by surgery in 8 cases, and improved in two. Immediate post-operative surveillance of the asthma revealed no cure. There were three immediate failures, and two recurrences before 6 months post-operative. Improvement was stable beyond 6 months in 5 patients (suppression or 80% reduction of corticosteroids in 3 cases, considerable reduction in the use of bronchodilators in 2 cases). Our results suggest that the surgical treatment of gastroesophageal reflux may be useful, at least for suppressing an aggravating factor in the respiratory illness.
Tardif
C
C
Groupe de Physiopathologie Respiratoire, Hôpital Charles-Nicolle, Rouen, France.
Nouvet
G
G
Denis
P
P
Tombelaine
R
R
Pasquis
P
P
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004417:Dyspnea / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014109:Total Lung Capacity / Q000502:physiology
D000897:Anti-Ulcer Agents; D001993:Bronchodilator Agents