Prevalence, pathophysiology, and treatment of patients with asthma and gastroesophageal reflux disease.
About one third of the US adult population experiences symptoms of gastroesophageal reflux on a monthly basis. Asthma is present in about 5% of the same population. This article reviews and summarizes the literature in the following areas: (1) prevalence of gastroesophageal reflux disease (GERD) in asthmatic patients based on clinical symptoms, endoscopic esophagitis, and 24-hour ambulatory esophageal pH recordings; (2) proposed pathophysiologic mechanisms linking the 2 diseases; and (3) medical and surgical treatment trial results of antireflux therapy for asthmatic patients. Asthmatic patients appear to have an increased prevalence of GERD symptoms and 24-hour esophageal acid exposure. The clinical management of these patients remains controversial. Common management approaches to GERD in asthmatic patients include medical therapy with a proton pump inhibitor and/or antireflux surgery, which improve asthma symptoms in many patients but minimally affect pulmonary function.
Alexander
J A
JA
Division of Gastroenterology and Hepatology and Internal Medicine, Mayo Clinic, Rochester, Minn. 55905, USA. alexander.jeffrey14@mayo.edu
Hunt
L W
LW
Patel
A M
AM
D000328:Adult; D000863:Antacids / Q000627:therapeutic use; D001249:Asthma / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D004942:Esophagitis, Peptic / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D004945:Esophagoscopy; D005744:Gastric Acid / Q000502:physiology; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006863:Hydrogen-Ion Concentration; D018670:Monitoring, Ambulatory; D015995:Prevalence; D054328:Proton Pump Inhibitors
D000863:Antacids; D054328:Proton Pump Inhibitors