The causal association between gastro-esophageal reflux disease (GERD) and difficult-to-control asthma is unclear.
Dr Wong and colleagues from Malaysia determined the prevalence of GERD and response to proton pump inhibitor (PPI) therapy in patients with difficult-to-control asthma.
The research team recruited consecutive patients with difficult-to-control asthma,
despite use of optimal asthmatic medications.
Difficult-to-control asthma was defined as persistent and recurrent symptoms.
The team diagnosed gastro-esophageal reflux disease by symptoms, gastroscopy and 24-hour esophageal pH monitoring.
All patients were prescribed a course of lansoprazole 30 mg daily for 8 weeks.
|Asthma symptoms improved in 75% with GERD on acid suppression therapy|
|Alimentary Pharmacology & Therapeutics|
The team assessed improvement to treatment by a change in pulmonary symptom score, and also by patient's subjective assessment of improvement.
The researchers diagnosed 17 of 30 patients having difficult-to-control asthma with gastro-esophageal reflux disease.
The team found that pulmonary symptom score improved significantly only in patients with gastro-esophageal reflux disease.
About 75% of patients with gastro-esophageal reflux disease reported an improvement in asthma symptoms.
The researchers noted that 9% without gastro-esophageal reflux disease reported mild symptom improvement.
There was no significant change in peak expiratory flow rate and forced expiratory volume.
Dr Wong's team commented, “More than half of patients with difficult-to-control asthma were diagnosed with gastro-esophageal reflux disease.”
“In these patients, the severity of asthma improved significantly with potent acid suppression therapy.”
“This underlines the critical role of acid reflux in this subset of patients with difficult-to-control asthma.”