Chest
Clinical InvestigationsESOPHAGUSGastroesophageal Reflux in Asthmatics: A Double-Blind, Placebo-Controlled Crossover Study With Omeprazole
Section snippets
Patients
In order to get as heterogeneous a group of asthmatic patients as possible, the only inclusion criteria was a diagnosis of asthma, which was made according to the guidelines defined by the American Thoracic Society.24 The patients were considered to have asthma if they had reversible bronchial obstruction, documented by a 15% increase in FEV1 after sympathomimetic inhalation, or a 20% decrease in FEV1 after methacholine challenge, or ≥ 20% diurnal variation in peak expiratory flow (PEF) values.
Results
Fifty-seven of 107 asthma patients (53%) were found to have pathologic GER in the ambulatory esophageal pH recording and were randomized. A comparison of the patients who had GER with those patients who did not have GER is shown in Table 1. Of the 57 patients with GER, 20 patients (35%) had no typical reflux symptoms.
Fifty-two patients completed both treatment periods. Three patients dropped out while receiving placebo treatment (two because of intense gastric symptoms), and two dropped out
Discussion
We found a high prevalence (53%) of GER in the asthmatic population. This is in accordance with previous studies, which have shown GER in 32 to 80% of asthmatic patients.1, 2 It is of interest that 35% of the patients who had GER in pH monitoring were free of typical reflux symptoms. Irwin et al31 have similarly shown GER to be clinically “silent” in 24% of asthmatic patients.
Although theophylline has been shown to reduce the pressure of the LES and thus potentially promote GER,32 it has been
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For editorial comment see page 1150.
This study was supported by the Finnish Anti-Tuberculosis Association Foundation, the Va¨ino¨ and Laina Kivi Foundation, and the Research Foundation of Respiratory Diseases.