A connection between GER and asthma was first appreciated in the late 1960s with reports of asthma patients being “cured” of asthma following surgery for hiatal hernia or GER.
The prevalence of GER in the general population is estimated to be 5-10% in both children and adults and in the asthmatic population.
This large variation in GER prevalence in asthmatics reflects substantial differences in the standards applied for establishing the diagnosis of both asthma and GER.
GER may be symptomatically silent in 24% of adults and in 50% of children.
Respiratory manifestations are the most common finding of GER in children.The association between asthma and GER or paranasal sinusitis will render their treatment difficult.
50% of asthmatics will have an abnormal lower esophageal sphincter. GER causes respiratory disease by three mechanisms (mechaniccal,neural or chemical).
Aspiration of gastric material may lead to mechanical luminal obstruction and chemical pnemonitis. Neural mechanism may cause bronchial constriction via stimulation of vagal nerve.
Medical and surgical ant reflux therapy has been reported to improve asthma symptoms and some patients were able to discontinue asthmatic drugs.
Using medications for the treatment of asthma may worsen GER.
Despite an extensive body of literature , many questions remain about the relationship between GER and asthma.