SELECTED ARTICLES FROM THE RECENT LITERATURE 2005

9/13/05

Acid suppression effects on asthma symptoms in GERD/asthma

Summary
Background - Epidemiologic studies have suggested an association between gastro-esophageal reflux disease (GERD) and worsening asthma. However, the pathogenic effects of GERD in asthma are still uncertain.

Findings - Stordal et al of Ostfold County Hospital in Norway investigated whether acid suppression therapy would reduce asthma symptoms in 38 children (mean age - 10.8 years) with concomitant chronic asthma and GERD. After baseline esophageal monitoring, subjects matched for asthma severity and degree of GERD were randomized to receive either omeprazole 20 mg/day or placebo.

After a 12 week treatment period, there was no significant difference in the change in asthma status (defined by symptom scores, quality of life and spirometry) between those treated with omeprazole vs placebo. After the same time, repeat esophageal monitoring showed a significant improvement in the median esophageal reflux scores in those treated with omeprazole.

Reference
 Arch Dis Child 2005;90:956-60

Editor's Comments
Installation of gastric acid into the esophagus can increase bronchial constriction in those with asthma. Therefore, one might expect that reduction of esophageal acidity in those with asthma and GERD would improve asthma control. Yet, the negative findings in this study, along with anecdotal reports suggest that therapy leading to increased esophageal pH does not drastically improve asthma status in those with asthma and GERD. The reasons for such lack of improvement are not yet clearly defined.

 

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