[Role of gastroesophageal reflux in asthma in infants and young children].
Gastroesophageal reflux (GER) occurs more frequently in asthmatic children than in general population. Esophageal pH recording data may be somewhat particular. The debate on GER increasing bronchial obstruction or GER being a parallel phenomenon remains controversial. Hypotheses are: acid microaspirations giving bronchospasm, vagally-transmitted reflex, or more probably coexisting phenomena. Pulmonary contamination is rarely seen during esophageal scintigraphy. Asthma symptoms are rarely clearly correlated to acid reflux episodes in pH-recording studies. However the esophageal acid infusion test may increase bronchial obstruction in adult asthmatics. Basically, when should one seek GER in asthmatic children? Many authors keep this for asthmatic children not responding to conventional treatment, also keeping in mind that GER-specific therapy efficacy is often difficult to appreciate in such patients. Briefly, one may speculate that GER improves with bronchodilator treatment in most cases.
Service de pédiatrie 2, hôpitaux universitaires de Strasbourg, Strasbourg, France. leonard.donato@chru-strasbourg.fr
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Donato
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Livolsi
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Gaugler
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Escande
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Weiss
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Ducoloné
D000402:Airway Obstruction / Q000150:complications / Q000209:etiology*; D001249:Asthma / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002675:Child, Preschool; D004947:Esophagus / Q000000981:diagnostic imaging; D005744:Gastric Acid; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011877:Radionuclide Imaging
D001993:Bronchodilator Agents