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)

We performed antireflux surgery on 13 adults with both gastroesophageal reflux (GER) and asthma. The duration of asthma ranged from 7 months to 43 yr. Twelve patients had chronic heartburn, 10 had nocturnal cough and wheezing, eight had chest pain, and one was asymptomatic for GER. GER was determined by a combination of esophagoscopy with biopsy, manometry, and esophageal pH testing. Postoperative follow-up ranged from 13 months to 5 yr. Six patients were completely free of all wheezing episodes, six still had wheezing but the frequency and severity had markedly decreased, and one remained unchanged. Of 11 patients who required chronic bronchodilator therapy, four were able to completely stop and six decreased the dose by more than half; one required the same amount of therapy. Of the seven corticosteroid-dependent patients, two were weaned completely, three were being tapered, one remained unchanged, and one required a smaller dose for nasal polyps although he was free of wheezing and had stopped bronchodilators. Three patients, all of whom dramatically improved after surgery, died during their follow-up course: one died suddenly 8 months postoperatively during a walk after dinner from apparent status asthmaticus; one died 9 months postoperatively of refractory congestive heart failure; and one died 30 months postoperatively of metastatic adenocarcinoma of unknown source. We conclude that surgical correction of GER in selected adults with both asthma and GER may significantly decrease or eliminate pulmonary symptoms and the need for asthmatic medications.
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PMID:Is gastroesophageal reflux a factor in some asthmatics? 381 16

This study was carried out on 104 patients of whom 94 were asthmatic and 10 patients presented with a spasmodic intractable cough; all presented with symptoms evocative of an associated gastro-oesophageal reflux (RGO). The clinical symptoms revealed a nocturnal cough (67%), cough preceeding asthma (46%) and heartburn in 60%. The asthma was severe (type III and IV in 89% of cases), or dependent on corticosteroids (37% of cases). pH monitoring of the oesophagus is the most sensitive examination (88% with positive results) slightly ahead of manometry and scintigraphy (both 81%), these examinations were clearly superior to radiographic examination (49%) and oesophageal fibroscopy (36%). The combination of pH monitoring and of scintigraphy enabled 98% of RGO cases to be identified by their clinical data. Medical treatment with Tagamet, Gaviscon and Primperan (alone or in combination) produced an improvement in the respiratory symptoms in 50% of the cases. Of the 14 surgically treated, 7 obtained an improvement in their respiratory symptoms. Seven of the ten patients with spasmodic cough were improved by medical treatment. Our study shows the frequency of oesophageal reflux in patients with severe asthma. In half of them RGO intervened as an aggravating factor and the medical treatment of RGO led to a clear improvement in the respiratory symptoms.
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PMID:[The association of asthma and gastroesophageal reflux: strategy of paraclinical studies]. 383 97

Three patients with esophageal reflux and associated pulmonary complications are presented: one with a lung abscess, another with recurring pneumonitis that required hospitalization, and the third with bronchospasm or asthma secondary to reflux and chronic aspiration. Two were treated surgically by the repair of esophageal and pulmonary lesions. The third patient was treated medically, with resolution of pulmonary symptoms and improvement of pulmonary function. A review is presented of the association between esophageal and pulmonary problems and of the insidious complications that may result.
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PMID:Pulmonary complications of benign esophageal disease. 394 67

Gastroesophageal reflux (GER) is a common cause of repeated emesis, failure to thrive, repeated pulmonary infection, and asthma in infants and children. During a 14-year period 270 children underwent gastroesophageal fundoplication for symptomatic reflux. The 24-hour esophageal pH monitoring is the most accurate test available to verify the presence of GER and is also helpful in evaluating the results of fundoplication. Transabdominal fundoplication may be performed with a low risk of complications. The most frequent complication requiring reoperation is paraesophageal hiatus hernia (6/270 patients), which should be repaired in almost all instances when symptoms develop. Closure of the crura posterior to the esophagus greatly reduces the incidence of this problem. Esophageal motility disorders occur in more than 35% of patients with symptomatic reflux and militate against performing a tight antireflux operation. Approximately 50% of patients with symptomatic reflux have associated gastric motility disorders. Radionuclide studies with 99mTC sulfur colloid in semisolid feedings have determined the magnitude of gastric retention after a feeding and have been helpful in identifying children who require a pyloroplasty with or without fundoplication. Pyloroplasty is performed simultaneously with fundoplication in approximately 10% of patients with symptomatic reflux when the lower esophageal sphincter pressure is low and the esophageal pH monitor shows reflux. The excellent clinical results achieved by fundoplication with or without pyloroplasty and the low morbidity and mortality rates indicate that these procedures should be used early in the management of infants and children who suffer symptomatic GER.
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PMID:Surgical management of the gastroesophageal reflux syndrome in childhood. 396 29

To demonstrate the existence and assess the magnitude of reflex bronchoconstriction in asthmatics, triggered by gastroesophageal reflux, pulmonary function studies (forced expiratory spirogram, flow-volume loops and airway resistance) were performed during a Bernstein test in 21 adult patients with intrinsic asthma and in 15 controls. Six asthmatics and 7 controls had symptomatic reflux test and a positive standard acid reflux test. Bernstein test was positive in all symptomatic individuals and in 2 asthmatics with a negative standard acid reflux test. Changes in pulmonary function occur only in asthmatics with symptomatic reflux. Decreases were: FEV1 8.4 +/- 3.4; FEF25-75% 45 +/- 7.3; Vmax 15 +/- 8.4; and Sgaw 16 +/- 3.7. Although changes were statistically significant (p less than 0.05), the magnitude of decrease is rather small and unlikely to be felt by an asthmatic or produce wheezy dyspnea. Therefore, even though the presence of acid in the lower esophagus may produce reflex bronchoconstriction in some asthmatics with symptomatic reflux, this appears to be of little significance.
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PMID:The significance of the reflex bronchoconstriction provoked by gastroesophageal reflux in bronchial asthma. 397 24

Lower esophageal sphincter pressure (LESP) and extended pH monitoring of the distal esophagus were assessed in 15 asthmatic children in order to evaluate the most important symptoms of suspected gastroesophageal reflux (GER)-asthma. As a result, episodes of asthmatic attacks after overeating were closely correlated with GER as determined by decreased LESP and high pH score.
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PMID:The evaluation of gastroesophageal reflux symptoms in patients with bronchial asthma. 398 26

The presence of gastro-oesophageal reflux was investigated in 18 children with moderate to severe asthma by overnight oesophageal pH monitoring. Appreciable reflux was found during sleep in eight; its relevance to nocturnal asthma was not clear. On another occasion the same children were challenged in a double blind fashion with a drink of dilute hydrochloric acid (0.001 N) and the response of the airways was monitored by peak flow measurements and by histamine challenge tests. There was a significant increase in mean histamine sensitivity (p = 0.001) 90 minutes after the acid drink without any associated change in baseline peak flow rate. Eight children had a significant response to the acid drink, and a further three reacted to a more concentrated solution (0.01 N). In those asthmatic children in whom reflux is associated with a positive response to an acid drink (five out of 18 in the present study) it seems likely that reflux exacerbates nocturnal symptoms.
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PMID:Gastro-oesophageal reflux and childhood asthma: the acid test. 403 29

Seventy-seven children with gastro-esophageal reflux have been operated upon during the last 21 years. Gradually added to the classical digestive symptoms and signs were those of respiratory disorders varying between asthma and the "missed sudden death" syndrome. Analysis of anatomical forms showed a predominance of cardio-antral malpositionings (58%) in this age group (mainly young babies). Surgical treatment, presently based on that of Toupet, apart from classical formal indications, is conducted after 3 to 4 months of medicopostural therapy when there is persistence of reflux and/or of esophagitis on fibroscopy in cardio-antral malpositions. Particularly as results of this surgery are good (disappearance of reflux in 83% of cases).
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PMID:[Surgical treatment of gastroesophageal reflux in children. Apropos of 77 cases]. 404 10

The significance of marked eosinophilic infiltration in esophageal mucosal biopsy specimens was evaluated in 11 patients. The patients were generally young, with an average age of 14.6 years; all had diffuse intraepithelial eosinophilia in several biopsies. Ten patients (91%) had evidence for reflux esophagitis, which was associated with esophageal stricture in three of the six patients older than 1 year. Marked esophageal eosinophilia might therefore indicate prolonged or severe gastroesophageal reflux. One patient with peripheral eosinophilia, a history of asthma, and concurrent idiopathic eosinophilic gastroenteritis lacked evidence of reflux and represents a case of idiopathic esophagitis. Critical review of the literature establishes three additional cases. Idiopathic eosinophilic esophagitis is an unusual variant of idiopathic, but presumably allergic, eosinophilic infiltration of the gastrointestinal tract.
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PMID:Marked eosinophilia in esophageal mucosal biopsies. 409 Nov 82

Five patients who had nocturnal asthma attacks associated with clinical symptoms of gastroesophageal reflux were studied to determine if antiasthma therapy could also benefit the reflux symptoms. The patients were treated in a randomized double blind fashion with either ephedrine or identical appearing placebo. During the treatment periods, the subjects maintained a daily record of asthma and reflux symptoms. Both asthma and reflux symptoms improved with active therapy. These results suggest that treatment of asthma may lessen the occurrence of gastroesophageal reflux.
J Asthma 1983
PMID:Asthma as a cause for, rather than a result of, gastroesophageal reflux. 635 63


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