Effect of intraesophageal acid instillation on airway reactivity in patients with asthma.

ABSTRACT

OBJECTIVE: To study the change in airway reactivity due to presence of acid in lower esophagus and its reversibility by antacid. METHOD: In this double blind study 12 subjects with asthma and gastroesophageal reflux received acid (N/10 hydrochloric acid) and antacid (mixture of magnesium trisilicate and aluminum hydroxide) perfusion in lower esophagus via a nasogastric tube. The four combinations were antacid-antacid (control), antacid-acid, acid-antacid and acid-acid. Airway reactivity (Histamine PD20) was recorded after each perfusion. RESULTS: Histamine PD20 significantly decreased (airway reactivity increased) (p < 0.05) with all three combinations containing acid as compared to control. No significant difference in airway reactivity was observed if the antacid was given before or after the acid. CONCLUSION: Presence of acid in lower esophagus can increase airway reactivity. This effect lasts longer than the presence of acid in esophagus itself.