PMID- 16430100
OWN - NLM
STAT- MEDLINE
DCOM- 20060221
LR  - 20061115
IS  - 0042-773X (Print)
IS  - 0042-773X (Linking)
VI  - 51
IP  - 12
DP  - 2005 Dec
TI  - [The relation of GERD, bronchial asthma and the upper respiratory tract].
PG  - 1341-50
AB  - Gastroesophageal reflux disease (GERD) is one of the most common diseases 
      affecting upper gastrointestinal tract. It is a chronic disease, whith stadily 
      growing incidence and prevalence in west countries during last 30 years. GERD is 
      caused by pathologic gastroesophageal reflux (GER). GERD includes endoscopically 
      positive, endoscopically negative and extraesophageal reflux disease. 
      Extraesophageal symptoms of GERD have been of a growing attention and discussion 
      during last few years. The most discussed topics are the relation of GERD and 
      bronchial asthma (BA), chronic cough and symptomatology from ear, nose and 
      throught (ENT) regions, but also non - cardial chest pain and many others. AIM: 
      In our clinic we ran a 5 years study which aim was to evaluate the presence of 
      GERD in patients with bronchial asthma, chronic cough and affections from ENT 
      regions. To assess if 3 months GERD treatment would improve lung function, 
      subjective complaints (cough) and GERD control in asthmatics; if this treatment 
      would allow to step - down with antiasthma medication. To assess if 3 months GERD 
      treatment can improve objective and subjective assessments in patients with 
      chronic cough and findings in ENT regions. As for GERD, we evaluated the 
      improvement of pH and subjective complaints (pyrosis). METHODS: We examined 86 
      patients with different severity of bronchial asthma, 54 patients with chronic 
      cough and 31 patients with ENT symptoms. All patients underwent 24 hour 
      esophageal pH metry, spirometry with lung function evaluation and objective ENT 
      examination by flexible laryngoscopy. In case of pathologic finding on 24 hour 
      pH-metry 3 months full antireflux treatment with proton pump inhibitors (PPI) and 
      prokinetics was introduced. After 3 months of GERD treatment we performed control 
      24 hour esophageal pH metry, control spirometry and ENT examination by flexible 
      laryngoscopy. Patients were asked to make their subjective symptoms assessments. 
      RESULTS: We found that GERD prevalence in patients with respiratory symptoms was 
      very high. Three months GERD treatment improved lung function (FEV1) with 
      statistical significance (p = 0.0319), and so improved GERD control (in 60.7% of 
      patients with high statistical significance p = 0.0009). Subjective complaints 
      (cough) also improved in most patients. 3 months GERD treatment did not allow to 
      step down with maintenance BA therapy according to GINA guidelines, but it 
      enabled to decrease the rescue medications in 50% of patients. Patients with 
      chronic cough can benefit from GERD treatment as cough improved in 75.8% of 
      patients. CONCLUSION: Objective findings as well as subjective complaints 
      improved in 75% of patients with ENT symptomatology. GERD control (DeMeester 
      score and pyrosis if present) was highly statistically significant in all three 
      groups of patients. It is necessary to mention, that there is a high presence of 
      nocturnal acid breakthrough (NAB) in patients with respiratory symptoms: 30.3 % 
      in patients with bronchial asthma, 63.6 % in patients with chronic cough and 45 % 
      of patients with ENT manifestations.
FAU - Matyasova, Z
AU  - Matyasova Z
AD  - Interni gastroenterologicka klinika Lekarske fakulty MU a FN Brno. 
      matyasovazuzana@quick.cz
FAU - Novotna, B
AU  - Novotna B
FAU - Matulova, M
AU  - Matulova M
FAU - Dolina, J
AU  - Dolina J
FAU - Kroupa, R
AU  - Kroupa R
FAU - Lanikova, Z
AU  - Lanikova Z
FAU - Znojil, V
AU  - Znojil V
FAU - Hep, A
AU  - Hep A
FAU - Dite, P
AU  - Dite P
LA  - cze
PT  - English Abstract
PT  - Journal Article
TT  - Vztah refluxni choroby jicnu k astmatu bronchiale a hornim cestam dychacim.
PL  - Czech Republic
TA  - Vnitr Lek
JT  - Vnitrni lekarstvi
JID - 0413602
SB  - IM
MH  - Adult
MH  - Aged
MH  - Asthma/*complications/drug therapy/physiopathology
MH  - Chronic Disease
MH  - Cough/physiopathology
MH  - Female
MH  - Gastroesophageal Reflux/*complications/drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Otorhinolaryngologic Diseases/*complications/physiopathology
EDAT- 2006/01/25 09:00
MHDA- 2006/02/24 09:00
CRDT- 2006/01/25 09:00
PHST- 2006/01/25 09:00 [pubmed]
PHST- 2006/02/24 09:00 [medline]
PHST- 2006/01/25 09:00 [entrez]
PST - ppublish
SO  - Vnitr Lek. 2005 Dec;51(12):1341-50.