title: Gastroesophageal reflux disease and childhood asthma.
abstract: OBJECTIVE
  Gastroesophageal reflux disease (GERD) is common in children with asthma and may be present with or without symptoms. Clinicians, influenced by position statements in national guidelines, have routinely treated children with poorly controlled asthma with various anti-GERD medications. This practice is based on the pervasive but unproven belief that GERD is an important determinant of poor asthma control.
  
  
  RESULTS
  Clinical studies show that GERD is highly prevalent in children with asthma, with estimates as high as 80%, but nearly half of the children are asymptomatic. However, there is no conclusive evidence per se that asymptomatic GERD informs asthma control, and treatment of GERD in the few controlled trials available for review does not substantively improve asthma outcomes. In a recent large controlled clinical trial, treatment with a proton-pump inhibitor (PPI) was not only ineffective, but adverse effects were common, including an increased prevalence of symptomatic respiratory infections.
  
  
  CONCLUSIONS
  Current evidence does not support the routine use of anti-GERD medications in the treatment of poorly controlled asthma of childhood. However large controlled trials of children symptomatic of both GERD and asthma have not been conducted, and in this case the benefits of treatment, although unproven, might outweigh the risks.
authors.affiliation: Biomedical Research Department, Center for Pharmacogenomics and Translational Research, Nemours Children's Clinic Jacksonville, Florida, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Blake
authors.forename: William G
authors.initials: WG
authors.lastname: Teague
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D019468:Disease Management; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D054328:Proton Pump Inhibitors