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Acid suppression and paediatric asthma
  1. S Birring
  1. Specialist Registrar in Respiratory Medicine, Glenfield Hospital, Leicester, UK;

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Gastro-oesophageal reflux is common in children with asthma but its relevance is unclear. The effects of proton pump inhibitors on asthma control in children are not known.

Thirty six children aged 7–16 years with mild to moderate asthma and symptomatic gastro-oesophageal reflux (identified on 24 hour oesophageal pH monitoring) were randomised to 3 months of treatment with omeprazole 20 mg once daily or placebo. There were no significant differences in asthma symptoms, quality of life, lung function, or short acting bronchodilator use between the omeprazole and placebo groups. Repeat oesophageal pH studies in a subset of children receiving omeprazole indicated adequate acid suppression. The results of this study argue against a causal relationship between acid gastro-oesophageal reflux and asthma morbidity, and are consistent with the findings of a recent Cochrane database meta-analysis.

The authors conclude that proton pump inhibitors are unhelpful in children with asthma who are already receiving conventional asthma treatment.

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