In children with both asthma and gastroesophageal reflux disease (GERD), treating the latter can improve the former, according to research presented Sunday at the annual meeting of the American College of Allergy, Asthma and Immunology in Seattle.
GERD is a common disease in which fluid from the stomach backs up into the esophagus, typically causing chronic heartburn and other symptoms, which can lead to erosion of the esophagus. In addition to drugs that reduce the secretion of this acidic fluid, GERD may be treated with a type of surgery called fundoplication that tightens the junction between the esophagus and stomach.
Previous studies in adults have suggested that as many as four out of five asthmatics experience the chronic cough and hoarseness of acid reflux. While the connections between asthma and GERD remain unclear, researchers have noticed that antireflux medications can sometimes help asthma symptoms.
"About two thirds of patients with asthma have underlying reflux and GERD has been implicated in provoking asthma," Dr. Vikram Khoshoo, a pediatric gastroenterologist from West Jefferson Medical Center, New Orleans, who was involved in the study, told Reuters Health.
To investigate this relationship further, he and his colleagues had 62 children, between 6 and 11 years old, with asthma undergo esophageal acid testing. Forty-four children with abnormal results suggestive of GERD received anti-reflux therapy (either medical or surgical), while the remaining 18 patients served as the comparison group and continued their asthma regimen.
After 2 years, children receiving anti-reflux therapy experienced less than one asthma flare-up per year, compared with almost three flare-ups per year among other children.
Breathing tests confirmed improved lung function with anti-reflux therapy.
"We found that when you take children with persistent asthma and GERD and treat them with anti-reflux medication, their asthma outcomes are better, they require significantly less asthma medication over the years, and they have fewer exacerbations of asthma," Khoshoo told Reuters Health.
GERD is being missed in a lot of children who have persistent asthma, Khoshoo noted. "I think the message has to be — if a child has persistent asthma without any risk factors or he has persistent asthma and despite adequate medication and compliance is not getting better, then it's possible that reflux may be playing a role."
When reflux is treated, there should be an improvement in symptoms outcome, a reduction in the need for asthma medications, and an improvement in lung function, he added.