Gastro esophageal Reflux (GER) and
Asthma
Summary
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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.
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