Gastric asthma: a pathophysiological entity?
BACKGROUND
Gastro-oesophageal reflux disease (GORD) is manifested by typical reflux symptoms and atypical extra-oesophageal symptoms. Important in this respect are respiratory conditions. Gastric asthma is a prominent example of these extra-oesophageal manifestations of GORD. There is, however, much debate about its prevalence, pathophysiology and clinical importance.


METHODS
Narrative review of the literature.


RESULTS
In asthmatics, the prevalence of GORD is generally reported to be higher than in normals, but with a wide range, probably due to patient selection. In a minority of asthmatics GORD aggravates or triggers asthma. The pathogenetic mechanisms can be a vagally transmitted reflex as well as micro-aspiration of refluxed material. The association with inflammatory mediator release has been insufficiently investigated. Selecting those who are likely to respond to anti-reflux measures is important: those with difficult to treat asthma, non-allergic asthma, adult-onset asthma with GORD. Oesophageal pH-metry to prove GORD and gastroscopy to diagnose Barrett's metaplasia are advisable.
Peters
F T
FT
Dept. of Gastroenterology, University Hospital Groningen, The Netherlands.
Kleibeuker
J H
JH
Postma
D S
DS
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy; D006801:Humans
D018927:Anti-Asthmatic Agents