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

The association between gastroesophageal reflux and respiratory disease is recognized long time ago. We can distinguish two kinds of asthma: asthma caused by a gastroesophageal reflux and asthma complicated by a gastroesophageal reflux. In the clinic evaluation it is important to establish the nature of reflux. It is essential to effect the Bernstein's test.
Arch Monaldi Mal Torace
PMID:[A case of asthma caused by gastroesophageal reflux. A clinical case]. 215 35

In order to determine whether the presence of a retrosternal pain sensitive to nitroglycerin is predictive of the finding of esophageal dyskinesia in patients with normal coronary angiography and negative methylergonovine test, we administered 0.8 mg of a nitroglycerin spray during esophageal manometry and after a methylergonovine or edrophonium provocation test. The effects of nitroglycerin on esophageal motility were recorded and compared with clinical data. Forty patients (21 men, 19 women, mean age 54 +/- 8 years) entered the study. In 22 of them (55 p. 100) the retrosternal pain was relieved by nitroglycerin within less than 5 minutes; the provocation test was positive in 10 cases (25 p. 100). In all patients nitroglycerin produced a highly significant decrease in the duration and amplitude of esophageal contractions. Among the 10 patients with esophageal dyskinesia, the duration of contractions was significantly more reduced (p less than 0.005) in those with nitroglycerin-sensitive pain (6 patients) than in those with nitroglycerin-resistant pain. These 6 patients, therefore, could be regarded clinically and manometrically as "responders" to nitroglycerin. Two of them had gastro-esophageal reflux. In contrast, among patients without induced esophageal dyskinesia the effects of nitroglycerin on manometry were the same irrespective of whether or not pain was usually relieved by nitroglycerin. The fact that pain was nitroglycerin-sensitive had no predictive value concerning the finding of esophageal dyskinesia by the provocation test (non-significant X2 test). We conclude that the clinical and manometric effects of nitroglycerin were concordant only in patients with induced esophageal dyskinesia; patients who responded to nitroglycerin could have a gastro-esophageal reflux.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1989 Jan
PMID:[Nitroglycerin and angina with angiographically normal coronary vessels. Clinical effects and effects on esophageal motility]. 249 72

We carried out a retrospective study of 132 cases of respiratory disorders associated with gastro-oesophageal reflux involving 66 children, 42 boys and 24 girls, 4 days to 10 years old with a mean of 22 months. We also studied 66 adults, 37 men and 29 women, 16 to 74 years old. In the infants the mean duration of respiratory disorders was 17 months and a recurrent broncho-pulmonary infection was the principal indication (40 cases). Alimentary symptoms were present in 34 cases. There was evidence of reflux in 60 cases. The suppression of any reflux was obtained surgically in 95% of cases with a disappearance of the respiratory disorders in 78.6% of cases and their improvement in 16.4% of cases with a mean follow up period of 4.3 years. In the adults the mean duration of the respiratory disorders was 9.7 years and asthma was the principal cause (38 cases). Alimentary symptoms were present in 56 cases with evidence of reflux in 64 cases. A suppression of the reflux was achieved surgically in 94% of cases with a disappearance of the respiratory disorders in 36% of cases and their improvement in 28% of cases with a mean follow up period of 4.7 years. The correlation between the disappearance of reflux and the respiratory symptoms and signs in the children should perhaps be tempered by the natural history of the maturation of the inferior oesophageal sphincter. However surgery shortens the danger period in serious situations which are life threatening.(ABSTRACT TRUNCATED AT 250 WORDS)
Rev Mal Respir 1989
PMID:[Respiratory signs associated with gastro-esophageal reflux. A retrospective study of 132 surgically treated cases in children and adults]. 260 28

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.
Rev Mal Respir 1985
PMID:[The association of asthma and gastroesophageal reflux: strategy of paraclinical studies]. 383 97

In order to study risk factors for gastroesophageal reflux (RGO), we have analysed the clinical particulars, the spirometry and the different therapies of chronic asthmatics with and without RGO. RGO has been studied using 24 hour pH manometry in 53 patients suffering from chronic asthma. 70% of these patients had RGO, defined as oesophageal pH below 4, for 4.2% or more of the total time. The only predictive factor for the presence of RGO (log regression) was the dose of theophylline (P is equal to 0.02) whose average dose was higher in cases of RGO (9.1 plus or minus 2.3 mg/kg against 6.3 plus or minus 1.7 mg/kg, P is less than 0.03). Although the severity of the asthma and the spirometric parameters were similar. On the other hand, the severity of RGO, assessed as the percentage of the total time passed with a pH below 4 or correlated (multiple regression) with longevity of the disease (P is equal to 0.02) and the dose of theophylline (P is equal to 0.001). These results suggest that the treatment with theophylline and the duration of the asthma could constitute risk factors for RGO in chronic asthma.
Rev Mal Respir 1993
PMID:[Risk factors for gastroesophageal reflux in chronic asthma]. 812 18

We report a case of interstitial pneumonia found by a woman who suffered from a gastroesophageal reflux unamenable to usual treatments. The HR-tomographic discovery of a tone esophagus lead to a manometric study. The association of high autoantibodies levels and radiographic and manometric data were characteristic of esophageal and pulmonary scleroderma.
Rev Mal Respir 1999 Nov
PMID:[Fortuitous discovery of infiltration of the lung bases]. 1061 60

Digestive disturbances are frequent in adults with cystic fibrosis. They can lead to malnutrition which in turn is deleterious to the prognosis. We summarise the information on epidemiology, pathogenicity, signs, diagnostic criteria and treatments of exocrine pancreatic insufficiency, gastro-oesophageal reflux and denutrition (which are all frequent) but also of constipation, rectal prolapse, distal intestinal obstruction syndrome, and liver diseases. The main recommendations are the following: 1--know how to treat pancreatic insufficiency with enzyme replacement and vitamins; 2--know how to treat aggressively any gastro-esophageal reflux; 3--diagnose and treat denutrition as early as possible; 4--know the distal intestinal obstruction syndrome to avoid abusive and dangerous surgery; 5--know that the most severe hepatic diseases can be treated by liver transplantation.
Rev Mal Respir 2000 Aug
PMID:[Digestive and nutritional management of adults with cystic fibrosis]. 1107 88

The treatment of asthma in children should not be fixed but rather must be regularly adapted to keep the condition under control defined according to clinical and functional criteria. In a child whose asthma is controlled, a step down in therapy should be carried out every 3 to 6 months to achieve the minimal effective level of treatment. In a child whose asthma appears not to be controlled, it is necessary initially to evaluate compliance with therapy and to seek aggravating factors which may include allergic rhinitis, multiple sensitisation, tobacco exposure, psychological factors, obesity, gastro- oesophageal reflux and infection. Where control of asthma is poor the main therapeutic strategy rests on an increase in the dose of inhaled corticosteroid and on the addition of other anti-asthmatic treatments--inhaled long--acting beta 2 agonists and oral leukotriene antagonists.
Rev Mal Respir 2009 Oct
PMID:[When and how to modify the management of asthma in children over the age of 4]. 1995 27

Systemic sclerosis (SSc) is a connective tissue disorder characterized by microvascular involvement, which very frequently targets the digestive tract. Gastrointestinal involvement is noted in up to 90% of cases, the segment most frequently involved being the esophagus although the entire digestive tract may be affected. Gastroesophageal reflux is the most common symptom but other unusual complications may also occur. Gastric antral vascular ectasia (GAVE) or watermelon stomach is one such rare lesion; it relates to a disturbed capillary bed, which appears dilated, sometimes with thrombi under the mucosa. This lesion is one expression of generalized SSc microvasculopathy. Its prevalence is not precisely known but appears to be weak; however, it remains a cause of anemia clinicians should be aware of. Indeed, specific local treatment must be delivered and is usually efficient despite frequent recurrent events.
J Mal Vasc 2010 Jul
PMID:[Watermelon stomach in systemic sclerosis]. 2045 85

Asthma exacerbations are responsible for many emergency medical interventions and account for a significant proportion of the health costs of the disease. Increased airway inflammation is a key feature of exacerbations in asthma and therefore inhaled corticosteroids (ICS) are considered as first-line therapy for long-term asthma control. ICS have been demonstrated to reduce the risk of asthma exacerbations, as well as improving lung function. Oral leukotriene receptor antagonists also reduce the incidence of asthma exacerbations but are less effective than ICS. In patients with inadequately controlled persistent asthma despite low-dose ICS, the addition of a long-acting inhaled beta-agonist (LABA) should be considered. LABA should not be given alone and should always be associated with ICS in asthma. The anti-immunoglobulin E antibody, omalizumab, reduces severe exacerbations and emergency visits in patients with severe allergic asthma. In clinical trials measurement of the inflammatory response in induced sputum could provide information concerning appropriate drug therapy. Asthma-associated comorbidities should be investigated and treated, particularly in severe asthma. Despite a high prevalence of both gastro-oesophageal reflux and allergic rhinitis among patients with asthma, treatment with proton-pump inhibitors or nasal corticosteroids does not reduce the rate of asthma exacerbations.
Rev Mal Respir 2012 Feb
PMID:[Asthma exacerbations: pharmacological prevention]. 2320 May 94


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