RESUMO
Gastroesophageal reflux disease [GERD] induced asthma is a common clinical disorder. The aim of this study was to evaluate the effect of both medical and surgical therapy of GERD in the management of GERD induced asthma. Forty patients who had a diagnosis of chronic asthma as well as symptoms suggestive of GERD, were subjected to pulmonary function tests and tests for GERD. They were first given medical therapy for both bronchial asthma and GERD. Twenty-two patients, who continued medical treatment, showed good response to medical therapy in the form of decreased symptom and frequency of asthma and reflux symptoms as well as improvement in the pulmonary function tests [p<0.05]. Fourteen of the remaining 18 patients who refused to continue medical treatment were subjected to surgical correction of GERD in the form of Nissen floppy fundoplication. The other 4 patients refused surgery. Ten patients showed marked clinical improvement in the asthma and GERD symptoms as well as significant improvement in the pulmonary function tests after surgery [p <0.05]. Four patients failed to show improvement of their asthma after surgery. Postoperative complications in the form of chest infection, wound sepsis, burst abdomen were reported in 8 of the patients who have had surgery. Over correction of incompetent cardia was seen in 4 patients and responded well to balloon dilatations. Death attributed to surgical interference was not recorded in this series. This study showed that control of GERD in patients with GERD induced asthma is mandatory and also highlighted that surgical treatment of GERD substantially improves patients with GERD induced asthma when medical therapy could not be maintained and should be considered in patients with GERD induced asthma