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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gastroesophageal reflux is an important cause of chronic pulmonary disease. Particularly, chronic bronchitis and asthma are two common conditions in which there may be a chicken-and-egg association between the pulmonary problems and the gastroesophageal reflux. This interesting relationship needs to be considered in any patient with chronic pulmonary disease in whom the condition is progressing in spite of adequate medical therapy, in whom the history strongly supports this concept, and in whom laboratory tests suggest a causal relationship. Recognition and treatment of gastroesophageal reflux, either medical or surgical, can lead to improvement in the pulmonary condition of a large number of patients.
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PMID:Gastroesophageal reflux and respiratory disorders: a review. 264 92

Forty eight patients with moderate to severe asthma were enrolled in a double blind crossover study designed to evaluate the effects of ranitidine treatment, 150 mg twice daily for four weeks, on gastro-oesophageal reflux, asthma control, and bronchial reactivity. All 48 had a history of reflux symptoms and 27 had in addition reflux associated respiratory symptoms. Thirty two patients had objective evidence of acid reflux on 24 hour pH monitoring (pH of less than 4 for more than 1% of the 24 hours) and 27 patients had a positive result in the acid perfusion test. Reflux symptoms were significantly improved after ranitidine treatment. Ranitidine treatment was associated with modest improvements in nocturnal asthma and daily use of inhaled bronchodilator drugs but there was no significant change in bronchial reactivity, lung function, peak flow, or the number of eosinophils in the blood. Comparisons between the effect of ranitidine treatment on asthma control were performed between patients with and without a history of reflux associated respiratory symptoms, with and without a positive result in the acid perfusion test, and with and without objective evidence of gastro-oesophageal reflux. A history of reflux associated respiratory symptoms was the only factor that predicted an improvement in asthma control after ranitidine treatment. These results indicate that antireflux treatment will produce only small improvements in asthma control in asthmatic patients with a history of gastro-oesophageal reflux.
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PMID:Effects of ranitidine treatment on patients with asthma and a history of gastro-oesophageal reflux: a double blind crossover study. 264 42

Gastroesophageal reflux provokes asthma in many patients. Conversely, asthma predisposes to gastroesophageal reflux. In many patients, reflux therapy will ameliorate asthma. Recognition of this relationship is facilitated by physician awareness, clinical history, selected laboratory tests, and ultimately, a careful monitoring of the response to antireflux therapy. With the introduction of effective medical antireflux therapy, the opportunity to benefit these patients has increased. Surgical management of reflux-provoked asthma remains an effective and useful alternative in selected patients.
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PMID:Gastroesophageal reflux and asthma. 266 60

The latest developments in the understanding of the etiopathogenesis of bronchial asthma in childhood are briefly described. The Authors emphasize the central role of inflammation and different cell types recruitment and distinguish three phases: early, late and chronic inflammation. Current views on bronchial hyperreactivity and the vicious circle represented by causative allergic and extra-allergic factors are discussed. Clinically, the role of respiratory infections, sinusitis, gastroesophageal reflux, and so-called asthma-equivalent symptoms (recurrent laryngospasm, asthma-equivalent chronic cough) are also discussed. Lastly, the pharmacologic activity of the main classes of drugs on the various stages of asthmatic response are reviewed and the rationale for appropriate use is presented.
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PMID:[Allergic bronchial asthma in childhood: etiopathogenic, clinical and therapeutic considerations]. 268 50

Some peculiar aspects of bronchial asthma in women are pointed out and critically examined. The course of asthma is considered during the typical endocrine phases in women (i.e. pregnancy, menstrual cycle and menopause). A worsening is often reported between the 29th and 36th week of pregnancy; the clinical status during pregnancy is attributed to the interaction between the positive effect of cortisol and the antagonism of DOCA, progesterone, aldosterone on the cortisol-glucocorticoid pulmonary receptors. Also the increase of hypotalamic concentration of noradrenaline which inhibits the pituitary-adrenal axis is considered among of the causes of the worsening of symptoms; moreover the increase of progesterone enhances the gastroesophageal reflux which acts as a trigger stimulus and causes bronchospasm. The therapeutic aspects are examined. All the pharmacologic principles are considered regarding the possible harm to the pregnant woman or the fetus. The oldest and well established molecules are considered the most reliable. Bronchial asthma is then examined with regard to menstrual cycle; pre-menstrual asthma is critically reviewed. The Authors conclude that there are neither conclusive data nor a specific therapy. Finally the pathogenesis of perimenopausal asthma is discussed. A possible hyperestrogenism with possible modification of the PGF2/PGE2 rate may be the cause of this syndrome.
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PMID:[Bronchial asthma in women: peculiar aspects]. 268 51

A case is described with pathological gastro-oesophageal reflux and nighttime bronchial asthma. Treatment with omeprazole resulted not only in improvement of gastro-oesophageal reflux but also in alleviation of asthmatic symptoms and increases in expiratory peak flow values. The possible pathophysiological mechanisms whereby gastro-oesophageal reflux may induce or aggravate asthmatic symptoms are discussed. At present it is not yet possible to predict which patients with bronchial asthma will benefit from antireflux therapy with respect to their pulmonary condition, but such treatment is warranted in all patients with bronchial asthma and proven pathological gastro-oesophageal reflux.
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PMID:Gastro-oesophageal reflux in patients with bronchial asthma. 269 11

Gastroesophageal reflux is an important cause of chronic respiratory disorders. In at least two common pulmonary conditions, chronic bronchitis and asthma, there may be a ying-yang association between the pulmonary disease and gastroesophageal reflux. Gastroesophageal-provoked disease needs to be evaluated in patients with chronic respiratory disease whose condition is progressing in spite of adequate medical therapy; whose history strongly supports this concept; and whose laboratory tests suggest a causal relationship. Recognition and treatment of gastroesophageal reflux, either medical or surgical, can benefit respiratory problems of many patients.
J Asthma 1989
PMID:Gastroesophageal reflux and diseases of the respiratory tract: a review. 270 34

We report the long-term results of surgical repair of gastroesophageal reflux in 44 asthmatic patients who underwent surgery more than five years earlier (mean = 7.9 +/- 1.5 years). The severe asthma was associated with clinically evident reflux, and repair was attempted by surgical technique Nissen transabdominal gastropexy, with the following results: total cure, 11 cases (25 percent); marked improvement, 7 (16 percent); moderate improvement, 11 (25 percent); no improvement, 15 (34 percent). Cure was attained in intrinsic asthma with a predominance of nocturnal crises, associated with nocturnal tracheitis and with significant reflux, objective signs of which had appeared before the beginning of the asthma. Other results concerned asthmas complicated secondarily by GER in which it was impossible to determine whether the reflux was only a complication, without effect on the respiratory illness, or exacerbating the asthma. The question of surgery in these patients should be considered with care, being reserved for cases of severe asthma, poorly controlled by antiasthmatic drugs, and complicated by a severe reflux that encompasses ulcerative esophagitis.
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PMID:Long-term results of surgical treatment for gastroesophageal reflux in asthmatic patients. 273 91

Seventy-five infants and children presenting during the period December 1984 to December, 1987 with the clinical features of vomiting, failure to thrive, chronic cough, recurrent pneumonia and atypical asthma were evaluated for gastroesophageal reflux by standard barium esophagram. Fifty six cases (74.7%) and as many as 80% of the infants studied had gastroesophageal reflux; Grade II reflux was seen in 12 cases, Grade III in 30 and Grade IV in 14 cases. The patients with gastroesophageal reflux were put on medical treatment. All the patients had subjective improvement after 6 weeks to 6 months of conservative treatment and none of them developed further complications of gastroesophageal reflux during a follow-up period varying from two months to fifteen months. Anti-reflux surgery was not considered owing to the subjective improvement in all the patients on conservative treatment. We conclude that gastroesophageal reflux is very common in infants and children and urge the need to evaluate the patients presenting with the symptoms suggesting gastroesophageal reflux by barium esophagram; conservative treatment is the mainstay in the management of these children.
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PMID:Gastroesophageal reflux in infants and children. 275 28

This paper reported the results of esophageal manometry, PH recording, X-ray and endoscopy of 55 patients of asthma and 19 controls. The results showed the patients of asthma had a higher incidence of esophageal morphological abnormalities (63.6%) and GER (65.5%) while LES static pressure was lower. In the group A (n = 34) with GER symptom, the incidence of esophageal morphological abnormalities (88.2%) and esophageal dynamic abnormality (32.4%) were significantly higher than those of group B without GER symptom (n = 21) (23.5%) (5%) and controls (15.7%) (5%). Therefore, we considered that for those asthmatics with digestive symptoms it is beneficial to take an examination of the esophagus.
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PMID:[A study on the morphologic and dynamics of abnormality of the esophagus and gastroesophageal reflux in patients with asthma]. 280 42


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