Gastroesophageal reflux disease and asthma: an intriguing dilemma.
BACKGROUND
Gastroesophageal reflux disease (GORD) is characterized by typical reflux symptoms and multiple atypical extraesophageal symptoms. Gastric asthma is a prominent extraesophageal manifestation of GORD. There is persistent debate about the pathophysiologic mechanisms triggering asthma by GOR.


METHODS
We conducted a review of the literature.


RESULTS
The pathogenic mechanism could be either a vagally transmitted reflex or an intratracheal aspiration of refluxed material. In both hypotheses, the role of inflammatory mediators has been proposed.


CONCLUSIONS
Neurogenic inflammation is a good theoretic basis for a pathogenic interpretation of the disorder. In atopic patients, food allergy has been recently proposed as a possible cause of GOR and associated respiratory symptoms, and it should be considered in the diagnostic work-up of all patients with GORD.
Astarita
C
C
Dipartimento di Internistica Clinica e Sperimentale F. Magrassi, Clinica Medicina Seconda Università di Napoli, Naples, Italy.
Gargano
D
D
Cutajar
M
M
Napolitano
A
A
Manguso
F
F
Abbate
G F
GF
D001249:Asthma / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005512:Food Hypersensitivity / Q000150:complications; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans