Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To evaluate the role of gastroesophageal reflux (GER) as a possible cause of recurrent pulmonary disease, 30 children, aged 1 to 18 years, were studied prospectively with esophageal function tests. These included esophagram (30 patients), esophageal manometry (29 patients), pH probe (Tuttle) test (29 patients), and esophagoscopy with esophageal biopsy (23 patients). The patients studied had either chronic asthma or two or more documented pneumonias within a one-year period. Nineteen (63%) had GER based on two or more positive tests. Eighteen had positive Tuttle tests; 13 had abnormal manometry studies; nine had esophagitis on biopsy; six had esophagitis on esophagoscopy; and five had reflux on esophagram. Of those with GER, 17 had a history of nocturnal cough and eight vomited during infancy. Children with recurrent pulmonary disease should have esophageal function testing to exclude GER as the cause.
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PMID:Recurrent pulmonary disease in children: a complication of gastroesophageal reflux. 44 Aug 2

The aims of this study were to evaluate the incidence of gastroesophageal reflux (GER) in chronic allergic steroid-dependent asthmatic children and to assess whether a medical antireflux regimen might improve pulmonary status of asthmatics found to have reflux. Nineteen patients had a determination of lower esophageal sphincter (LES) pressure, pH assessment after acid instillation into the stomach (acid reflux test), and esophagram. After the reflux evaluation, an antireflux regimen was instituted for three weeks; patients were followed with asthma symptom diaries and weekly pulmonary function tests for this period and for another three weeks after finishing the regimen. Gastroesophageal reflux, diagnosed by positive acid reflux test, occurred in nine patients. Five patients had low LES pressure (less than or equal to 12 mm Hg), and two patients had an abnormal esophagram. There were no significant changes in asthma symptoms or pulmonary function tests with the medical antireflux regimen. Although GER does exist in a high percentage of this patient sample (47%), a short-term antacid and positional antireflux regimen does not improve the pulmonary status of these patients.
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PMID:Gastroesophageal reflux in steroid-dependent asthmatic youths. 44 Aug 9

The study comprised 458 infants complaining of recurrent obstructive bronchitis from the clinical, chest X-rays and gastroesophageal reflux investigation view points. Spontaneous radiological reflux was found in 49.1% of the patients, although a history of vomiting was present only in 26.6%. In infants with positive radiological reflux, manometrics showed a shorter gastroesophageal sphincter and with lesser pressures than a group of normal infants. With medical treatment of the reflux, remission of the respiratory symptoms was seen in 63.5% of the patients. In a group of infants treated, control X-rays, and manometrics were practiced at the end of the medical treatment showing significant improvement of pressure and length of the gastroesophageal sphincter. The long-term follow-up in infants showing failure of the medical treatment, bronchial asthma appeared in 56.6%.
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PMID:[Recurrent obstructive bronchitis in infants]. 57 85

In 196 cases of gastro-oesophageal reflux, simple or connected to a hiatal hernia or to a cardio-tuberous misplacement, the respiratory signs that are found in 1 patient out of 4, are analyzed. The nocturnal fits of coughing (39 cases, 20% of the reflux) is the most frequent sign of laryngo-tracheal aspiration of stomach content. This symptom of great diagnostic value, though neglected, should be looked for systematically. Other troubles are less frequent: bouts of recurring broncho-pulmonary infections, asthma attack, Mendelson's syndrome, pulmonary fibrosis. In absence of a patent cause, the symptoms should lead to suspect a reflux of stomach content in the airways. Similarly to oesophagitis, respiratory signs represent a complication sometimes serious, of gastro-oesophageal reflux, needing more frequently a surgical treatment of hiatal herniae or of the cardiac inefficiency.
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PMID:[Broncho-pulmonary manifestations and gastroesophageal reflux]. 61 79

The respiratory symptoms of gastro-oesophageal reflux, which sometimes includes massive and fatal inhalation, are well-known in infants. In older children the digestive signs are not clinically evident and the reflux mainly, if not exclusively, can be translated by recurring respiratory symptoms. The series of 36 cases presented in this work concerns children between 3 months and 15 years old, for whom the first signs were respiratory, with often a silent gastro-oesophageal reflux for several months, and even several years in some cases. The physiopathology of the respiratory symptoms concerns principally the repeated alimentary aspiration and/or gastric content during nocturnal decubitus. The pulmonary lesions caused by the reflux can be either localized, with atelectasis, obstructive emphysema or bronchiectasis, or generalized with granulomatous reactions around the food particles. Other respiratory conditions such as asthma or cystic fibrosis can be also associated with gastro-oesophageal reflux. The diagnostic criteria are discussed.
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PMID:[Recurrent bronchopneumopathies caused by gastroesophageal reflux in children. Clinical, x-ray and histologic studies of 36 cases]. 61 80

Gastroesophageal reflux is the commonest esophageal cause of chronic intermittent aspiration. The authors investigated 1000 consecutive patients with reflux with reference to their medical history, and by barium esophagography, esophageal manometry and pH studies. In patients with respiratory complications, chest roentgenography and pulmonary function tests were also performed. Of the total number, 279 patients aspirated either by coughing and choking during swallowing or as a result of night reflux; of these, 159 had associated respiratory symptoms, which included cough, voice change, recurrent respiratory infection, bronchiectasis and asthma. Of the patients with aspiration, 120 had surgical correction of reflux because conservative management failed. This form of reflux control improved the symptoms of cough and voice change and the condition of patients with recurrent infections or bronchiectasis, but alleviated the symptoms in only 8 of 28 asthmatic persons.
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PMID:Aspiration and gastroesophageal reflux. 67 82

Gastroesophageal reflux (GER) has been recognized with increasing frequency as the source of a wide variety of symptoms in infants and children. During the past 8 years at the UCLA Hospital, 74 patients under 18 years of age have been identified as having sufficiently severe symptomatic reflux to warrant gastroesophageal fundoplication. Although repeated emesis was the most common primary symptom, failure to thrive was a major symptom in 20 patients, repeated pneumonia in 18, asthma in five, and dysphagia owing to stricture in 12. Nine patients with previously repaired esophageal atresia had severe reflux. Serious neurologic disorders were present in 14 children. The diagnosis of reflux in the majority of symptomatic children was established by combining the findings of an abnormal esophagogram, Tuttle test, esophageal manometry, and esophagoscopy with biopsy. Six infants experienced repeated symptomatic GER although results of all diagnostic studies were normal. Each of the patients had undergone an unsuccessful trial of medical management before the decision to operate was made. Transabdominal Nissen fundoplication with gastrostomy was performed on each of the 74 children (28 under 1 year of age). Each of the strictures was successfully managed by postoperative dilatations. No death and no major complications occurred, but six patients experienced transient dysphagia and four had delayed gastric emptying. Every patient has been relieved of clinical reflux, and the pulmonary status in each, including the asthmatic children, has been markedly improved. On the basis of this favorable experience with 74 patients, we believe that an aggressive surgical approach should be taken in the management of symptomatic GER in infants and children who fail to respond to an adequate trial of medical management.
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PMID:Gastroesophageal fundoplication for the management of reflux in infants and children. 70 70

Hoarseness, asthma, and bronchitis are common but sometimes obscure manifestations of gastroesophageal reflux, the etiology of when respiratory symptoms predominate. In 300 consecutive patients who underwent surgical correction for gastroesophageal reflux, 129 (43%) had major respiratory complaints. Group 1 patients (82, 64%) were those referred for respiratory problems alone. In Group 2 (patients referred because of peptic complaints), 47 had associated respiratory problems in various combinations, including an additional 10 patients who had bronchiectasis. Treatment with appropriate surgical resection, in addition to antireflux procedures, was carried out in these people. Noticeable relief of respiratory symptoms was obtained in 96 (74%) of the 129 patients; 30 were improved and 2 were unchanged. Recurrent hiatus hernia or esophagitis was documented in 21 (7%) of the 300 patients.
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PMID:Hiatus hernia and the respiratory tract. 92 77

Of 28 patients with severe asthma routinely examined with upper gastrointestinal (UGI) x-ray films, 18 (64%) were found to have hiatus hernia and 13 (46%) were found to have demonstrable gastroesophageal reflux. These prevalences differed significantly (P less than .001) from those seen in a control population (19% and 5%, respectively). These data suggest that aspiration of gastric acid is a frequent incitant to severe asthma and that it should be routinely sought in the treatment-resistant asthmatic patient. Intensive medical regimens directed against reflux and acidity may bring notable improvement in asthma symptoms. Surgical restoration of effective lower esophageal spincter function has proved to be curative in other reported studies.
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PMID:Intrinsic asthma in adults. Association with gastroesophageal reflux. 103 35

Asthma is now considered primarily an inflammatory disease in which bronchospasm occurs secondary to airway inflammation. Management strategies include the use of inhaled anti-inflammatory agents, notably inhaled corticosteroids and cromolyn. Mild intermittent asthma may be treated with inhaled bronchodilators. Moderate asthma should be treated with an inhaled anti-inflammatory agent in addition to an inhaled beta agonist. If symptoms persist, an oral bronchodilator (either a beta-adrenergic agonist or theophylline) should be added. Therapy for severe asthma includes combinations of the foregoing medications, with the possible addition of oral corticosteroids. Other aspects of management include the use of a spacer device with inhaler therapy, control of concomitant allergies and triggering factors such as chronic sinusitis, tobacco smoke and gastroesophageal reflux, and home use of a portable peak flow meter to monitor the disease.
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PMID:National guidelines for the management of asthma in adults. 135 47


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