Medical antireflux treatment for asthma associated with gastroesophageal reflux

ABSTRACT

Thirty patients with non-allergic bronchial asthma associated with gastroesophageal reflux [GER], were studied before and after 9 weeks of antireflux medical therapy [ranitidine HCl]. All patients were subjected to full clinical history and examination, chest roentgenogram, ventilatory function tests, and tests to confirm GER [Bernstein test, Tuttle test, upper gastroesophageal endoscopy including taking biopsy from lower esophageal mucosa for histopathological examination]. Esophageal and pulmonary symptoms scores were recorded weekly. Endoscopic evidence of GER was shown in 63% of cases, while histopathologically esophagitis was proved in 96%. 9-week antireflux medical treatment was associated with rapid and dramatic response of reflux symptoms in 80% of cases and with more delayed and less dramatic improvement in pulmonary symptoms in 87% of case, evidenced subjectively by decline of both esophageal and pulmonary symptoms scores. Objectively esophageal erosions were diagnosed endoscopically in 16 out of 19 patients and healed completely. Ventilatory function tests also significantly improved [P <0.01]. It was concluded that there is a subset of patients in whom bronchoconstriction is triggered by GER. Treatment of the reflux in such patients improved their asthma