Gastro-oesophageal reflux and childhood asthma: the acid test.
The presence of gastro-oesophageal reflux was investigated in 18 children with moderate to severe asthma by overnight oesophageal pH monitoring. Appreciable reflux was found during sleep in eight; its relevance to nocturnal asthma was not clear. On another occasion the same children were challenged in a double blind fashion with a drink of dilute hydrochloric acid (0.001 N) and the response of the airways was monitored by peak flow measurements and by histamine challenge tests. There was a significant increase in mean histamine sensitivity (p = 0.001) 90 minutes after the acid drink without any associated change in baseline peak flow rate. Eight children had a significant response to the acid drink, and a further three reacted to a more concentrated solution (0.01 N). In those asthmatic children in whom reflux is associated with a positive response to an acid drink (five out of 18 in the present study) it seems likely that reflux exacerbates nocturnal symptoms.
D000293:Adolescent; D001249:Asthma / Q000209:etiology* / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D002648:Child; D005260:Female; D005764:Gastroesophageal Reflux / Q000139:chemically induced / Q000150:complications* / Q000503:physiopathology; D006632:Histamine; D006801:Humans; D006851:Hydrochloric Acid; D006863:Hydrogen-Ion Concentration; D008297:Male; D010366:Peak Expiratory Flow Rate
D006632:Histamine; D006851:Hydrochloric Acid