Journal of Indian Association of Pediatric Surgeons
Journal of Indian Association of Pediatric Surgeons
                                                   Official journal of the Indian Association of Pediatric Surgeons                           
Year : 2007  |  Volume : 12  |  Issue : 2  |  Page : 105--106

Gastroesophageal reflux disease and bronchial asthma in children: A surgical point of view


Mohammed A Youssef1, Hany Sedky2, Mohammed A El-Gohary3,  
1 Department of Pediatric Surgery, Alexandria Hospital for Sick Children, Alexandria, Egypt
2 Department of Pediatrics, TIBA Hospital, Alexandria, Egypt
3 Department of Pediatric Surgery, Al-Marfaq Hospital, Abu Dhabi, United Arab Emirates

Correspondence Address:
Mohammed A Youssef
Department of Pediatric Surgery, Alexandria Hospital for Sick Children, Alexandria
Egypt




How to cite this article:
Youssef MA, Sedky H, El-Gohary MA. Gastroesophageal reflux disease and bronchial asthma in children: A surgical point of view.J Indian Assoc Pediatr Surg 2007;12:105-106


How to cite this URL:
Youssef MA, Sedky H, El-Gohary MA. Gastroesophageal reflux disease and bronchial asthma in children: A surgical point of view. J Indian Assoc Pediatr Surg [serial online] 2007 [cited 2020 Dec 3 ];12:105-106
Available from: https://www.jiaps.com/text.asp?2007/12/2/105/33238


Full Text

Sir,

Gastroesophageal reflux disease (GERD) is a factor that is often neglected in the etiopathogenesis of asthma. The estimated incidence of GERD in asthmatic children reaches 50-60% and is higher than the incidence of GERD in the general population. [1] Some asthmatic patients present with typical symptoms of GERD, such as heartburn, regurgitation, water brash. Sometimes, reflux-like symptoms like hoarseness, sore throat, thoracic pain, cough or wheezing may precede an episode of asthma. The relationship of GERD and asthma is complex and continues to be debated. Patients with asthma have been shown to have excess acid reflux into the esophagus confirmed by endoscopic evidence of esophagitis in 39% of asthmatics. [2]

Our study included 70 children aged four months to eight years (mean = 34 months) who presented with persistent respiratory symptoms lasting beyond four weeks or had recurrence of these symptoms and were resistant to medical treatment. None of them had any family history of asthma or atopic disease or had parents who smoked. Forty five (64%) of these asthmatic children showed evidence of GERD by endoscopy and pH [3],[4] However, the underlying mechanism for this excess reflux is not known.

The presence of nocturnal symptoms and hoarseness of voice are significant clinical predictors of GER in asthmatic patients. GERD is significantly more common in nonatopic children with asthma-like airway disease compared to the controls and clinical improvement is significant after acid suppressor treatment. Thus, we suggest that children with the diagnosis of nonatopic asthma with recurrent exacerbations despite adequate asthma treatment have a high frequency of GER and that lansoprazole treatment may be considered early in its management. [5]

References

1Khoshoo V, Haydel R, Saturno E. Gastroesophageal reflux disease and asthma in children. Curr Gastroenterol Rep 2006;8:237-43.
2Sontag SJ, Schnell TG, Miller TQ, Khandelwal S, O'Connell S, Chejfec G, et al . Prevalence of oesophagitis in asthmatics. Gut 1992;33:872-6.
3Sontag SJ, O'Connell S, Khandelwal S, Miller T, Nemchausky B, Schnell TG, et al . Most asthmatics have gastroesophageal reflux with or without bronchodilator therapy. Gastroenterology 1990;99:613-20.
4Wesseling G, Brummer RJ, Wouters EF, ten Velde GP. Gastric asthma? No change in respiratory impedance during intraesophageal acidification in adult asthmatics. Chest 1993;104:1733-6.
5Kjellιn G. Association of esophageal dysfunction and asthma: Improvement in asthma with conservative management of esophageal signs. Int Med Specialist 1982;3:54-62.