title: A preliminary investigation of anti-reflux intervention for gastroesophageal reflux related childhood-to-adult persistent asthma.
abstract: BACKGROUND
  Childhood-to-adult persistent asthma is usually considered to be an atopic disease. However gastroesophageal reflux may also play an important role in this phenotype of asthma, especially when it is refractory to pulmonary medicine.
  
  
  METHODS
  Fifty-seven consecutive GERD patients who had decades of childhood-to-adult persistent asthmatic symptoms refractory to pulmonary medication were enrolled. GERD was assessed by a symptom questionnaire, endoscopy, reflux monitoring, and manometry, and treated by Stretta radiofrequency (SRF) or laparoscopic Nissen fundoplication (LNF). The outcomes were followed up with a questionnaire for an average of 3.3 ± 1.1 years.
  
  
  RESULTS
  Upper esophageal sphincter hypotonia, lower esophageal sphincter (LES) hypotonia, shortened LES, and esophageal body dyskinesia were demonstrated by esophagus manometry in 50.9%, 43.9%, 35.1%, and 45.6% of the patients, respectively. The symptom scores for heartburn, regurgitation, coughing, wheezing, and chest tightness significantly decreased from 5.8 ± 2.0, 5.6 ± 2.0, 7.3 ± 1.6, 8.4 ± 1.2, and 8.1 ± 1.5, to 1.2 ± 1.8, 1.1 ± 1.6, 2.8 ± 2.5, 3.8 ± 2.7, and 3.9 ± 2.7, respectively, after anti-reflux treatment (P < 0.001).
  
  
  CONCLUSIONS
  Esophagus dysfunction is high in childhood-to-adult persistent asthmatic patients with GERD. SRF and LNF are both effective for esophagus symptoms as well as persistent asthmatic symptoms for these patients. GER may relate with asthmatic symptoms in some patients. Evaluating asthmatic patients for possible treatment of the underlying cause, such as GERD, may improve symptoms and prevent disease persistence.
authors.affiliation: Center for GERD, The Second Artillery General Hospital PLA, Beijing Normal University, No. 16 Xinwai Street, Xicheng district, Beijing, China.
authors.forename: Zhi Wei
authors.initials: ZW
authors.lastname: Hu
authors.affiliation: Center for GERD, The Second Artillery General Hospital PLA, Beijing Normal University, No. 16 Xinwai Street, Xicheng district, Beijing, China ; Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhong Gao
authors.initials: ZG
authors.lastname: Wang
authors.affiliation: Center for GERD, The Second Artillery General Hospital PLA, Beijing Normal University, No. 16 Xinwai Street, Xicheng district, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Center for GERD, The Second Artillery General Hospital PLA, Beijing Normal University, No. 16 Xinwai Street, Xicheng district, Beijing, China.
authors.forename: Ji Min
authors.initials: JM
authors.lastname: Wu
authors.affiliation: Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Wei Tao
authors.initials: WT
authors.lastname: Liang
authors.affiliation: Center for GERD, The Second Artillery General Hospital PLA, Beijing Normal University, No. 16 Xinwai Street, Xicheng district, Beijing, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Center for GERD, The Second Artillery General Hospital PLA, Beijing Normal University, No. 16 Xinwai Street, Xicheng district, Beijing, China.
authors.forename: Shu Rui
authors.initials: SR
authors.lastname: Tian
authors.affiliation: Department of Respiratory Medicine, Artillery General Hospital, Beijing Normal University, Beijing, China.
authors.forename: Ai E
authors.initials: AE
authors.lastname: Wang
keywords: Asthma; Gastroesophageal reflux; Laparoscopic nissen fundoplication; Stretta radiofrequency