Vaccination News Home Page                                            subscribe Vaccination NewsLetter

http://www.chestjournal.org/cgi/content/abstract/123/4/1008

Full Text of this Article Reprint (PDF) Version of this Article Email this article to a friend eLetters: Submit a response to this article Similar articles found in: Chest Online PubMed PubMed Citation Search Medline for articles by: Khoshoo, V. || Nelson, C. Alert me when: new articles cite this article   Download to Citation Manager

(Chest. 2003;123:1008-1013.)
© 2003 American College of Chest Physicians
 

Role of Gastroesophageal Reflux in Older Children With Persistent Asthma^*

Vikram Khoshoo, MD, PhD; Thao Le; Robert M. Haydel, Jr, MD; Lisa Landry, LPN and Carl Nelson, MS, RRT

^* From the West Jefferson Medical Center, New Orleans, LA.

Correspondence to: Vikram Khoshoo, MD, PhD, 4709 Butternut Place, Midland, MI 48640; e-mail: vkhoshoo@earthlink.net

Background: Gastroesophageal reflux (GER) plays a role in inducing or exacerbating asthma.

Methods: We evaluated asthma outcome before and after anti-GER treatment in older children (age range, 5 to 10.5 years) who had persistent moderate asthma and were being treated with short- and long-acting bronchodilators, inhaled corticosteroids, and leukotriene antagonists. Forty-six such consecutive children underwent extended esophageal pH monitoring. Of the 27 patients (59%) who had evidence of GER disease, 18 patients underwent medical treatment (lifestyle changes, proton pump inhibitors, and prokinetics) and 9 patients opted for surgical treatment (Nissen fundoplication) of GER. Of the 19 patients with normal pH study findings, 8 patients underwent empiric medical anti-GER treatment and the remaining 11 patients served as a control group. Data on all patients were collected from 6 months prior to performing the pH studies and for 12 months after initiation of anti-GER treatment. The frequency of oral and inhaled corticosteroids, short- and long-acting bronchodilators, and leukotriene antagonists was prospectively recorded.

Results: There was a significant reduction in the use of short- and long-acting bronchodilators as well as inhaled corticosteroids after anti-GER treatment was instituted in patients with GER disease (p < 0.05). Two patients (25%) without evidence of GER disease showed significant reduction in need for asthma medication after anti-GER treatment, but none of the patients without GER disease and no GER treatment showed any significant reduction in the need for asthma medications.

Conclusions: Anti-GER treatment in patients with GER disease and asthma results in a significant reduction in the requirement of asthma medications.

Key Words: asthma • asthma medications • gastroesophageal reflux

Copyright © 2003 by the American College of Chest Physicians.

Vaccination News Home Page

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.