ASTHMA AND GASTROESOPHAGEAL REFLUX DISEASE

Abstract

It iswell known that astma and gastroesophageal reflux disease (GERD) are related. Respiratory symptoms, associated with asthma, are more frequent among patients with GERD. GERD is diagnosed twice more often for asthmatic patients than patients without asthma. It is difficult to evaluate the pathogenesis of these two co-existing diseases. There are three main mechanisms how gastroesophageal reflux may exacerbate airflow obstruction in asthmatics: increased vagal tone, heightened
bronchial reactivity, and microaspiration. Themain GERD diagnostic aspects for asthmatics are anamnesis, typical and atypical GERD symptoms, upper gastrointestinal tract endoscopy, oesophageal pH testing, empiric therapywith a proton pump inhibitor
(PPI) (PPI test). For patients withmoderate to severe asthma and symptoms of gastroesophageal reflux, particularly those with regurgitation symptoms or nocturnal asthma, empiric therapy with a PPI taken twice daily, 30 minutes before breakfast and dinner for three months, should be recommended. Referral to a gastroenterologist is indicated if GERD symptoms are not controlled on PPI therapy or if the patient has alarming symptoms. Consensus has not been yet achieved on the role of surgery
in patients with asthma-associated GERD.