A team from New South Wales, Australia, conducted a systematic literature review to assess the effect of treating reflux esophagitis on asthma outcomes.
Randomized controlled trials of reflux esophagitis treatment in adults or children that reported asthma health outcomes were included. Each was assessed in accordance with the standard Cochrane systematic review process.
Patients were typically adults with asthma and concurrent symptomatic gastro-esophageal reflux who received interventions that included pharmacological therapy, conservative management, and surgery.
The outcomes measured were lung function, peak expiratory flow, asthma symptoms, asthma medications, and nocturnal asthma.
Inconsistent results from treatment of reflux esophagitis as a means of controlling asthma|
From 22 potentially relevant published and unpublished randomized controlled trials, 12 were included. Treatment duration ranged from 1 week to 6 months.
The researchers found that 8 trials reported that treatment improved at least one asthma outcome, but these outcomes differed between trials.
Overall, treatment of reflux esophagitis did not consistently improve forced expiratory volume in one second (FEV1), peak expiratory flow rate, asthma symptoms, nocturnal asthma symptoms, or use of asthma medications in asthmatic subjects.
Significant improvement in wheeze was reported in two studies.
Dr J L Coughlan, of the John Hunter Hospital, New South Wales, said on behalf of the group, "The published literature does not consistently support treatment of reflux esophagitis as a means of controlling asthma."
"Further large randomized controlled trials in subjects with a demonstrated temporal relationship between gastro-esophageal reflux and asthma are needed. These trials should be conducted over at least 6 months to allow adequate time to observe a treatment effect," it was concluded.