Prevalence, pathophysiology, and treatment of patients with asthma and gastroesophageal reflux disease

• Published in: Mayo Clinic proceedings Vol. 75; no. 10; p. 1055
• Main Authors: Alexander, J A, Hunt, L W, Patel, A M
• Format: Journal Article
• Language: English
• Published: England 01-10-2000
• Subjects: Adult; Antacids - therapeutic use; Asthma - complications; Asthma - physiopathology; Asthma - therapy; Esophagitis, Peptic - complications; Esophagitis, Peptic - physiopathology; Esophagitis, Peptic - therapy; Esophagoscopy; Gastric Acid - physiology; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - drug therapy; Gastroesophageal Reflux - physiopathology; Gastroesophageal Reflux - surgery; Humans; Hydrogen-Ion Concentration; Monitoring, Ambulatory; Prevalence; Proton Pump Inhibitors
• ISSN: 0025-6196
• DOI: 10.4065/75.10.1055

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.