Spontaneous gastroesophageal reflux and airway patency during the night in adult asthmatics.

Controversies still exist on the role of nighttime gastroesophageal reflux (GER) in precipitating nocturnal asthma. We tested the relationship between GER and nocturnal bronchoconstriction by continuously and simultaneously monitoring both respiratory resistances and esophageal pH in seven asthmatics with moderate to severe GER disease. Twenty-nine GER episodes were found during the study night lasting more than 5 min (LGER) and 72 not longer than 5 min (SGER). Both long (LGER) and short (SGER) gastroesophageal refluxes were able to maintain significantly higher lower respiratory resistances (RLR) at the resolution of each GER episode (RLR(e)) with respect to baseline values. RLR, expressed as the area under the RLR curve along each GER episode (AUCR(LR)) and as RLR(e), showed significant correlations with GER duration. Moreover, a significant correlation was found between RLR measured 10 min after GER resolution and GER duration during each episode. We conclude that GER itself is able to elicit nocturnal bronchoconstriction in asthmatics with moderate to severe GER disease and that bronchoconstriction severity and duration are related to GER duration.

[1]  H. Coghlan,et al.  Autonomic regulation in asthmatics with gastroesophageal reflux. , 1997, Chest.

[2]  J. Richter,et al.  Asthma and gastroesophageal reflux: acid suppressive therapy improves asthma outcome. , 1996, The American journal of medicine.

[3]  A. Pilotto,et al.  A comparison of five maintenance therapies for reflux esophagitis. , 1995, The New England journal of medicine.

[4]  G. Salvia,et al.  Simultaneous prolonged recordings of proximal and distal intraesophageal pH in children with gastroesophageal reflux disease and respiratory symptoms. , 1995, The American journal of gastroenterology.

[5]  D. Altman,et al.  Calculating correlation coefficients with repeated observations: Part 2—correlation between subjects , 1995, BMJ.

[6]  D. Altman,et al.  Statistics notes: Calculating correlation coefficients with repeated observations: Part 1—correlation within subjects , 1995 .

[7]  J. Richter,et al.  Gastroesophageal reflux-induced bronchoconstriction. Is microaspiration a factor? , 1994, Chest.

[8]  J. Richter,et al.  Gastroesophageal reflux-induced bronchoconstriction. An intraesophageal acid infusion study using state-of-the-art technology. , 1994, Chest.

[9]  R. J. Butland,et al.  Omeprazole in the treatment of asthmatics with nocturnal symptoms and gastro-oesophageal reflux: a placebo-controlled cross-over study. , 1994, Postgraduate medical journal.

[10]  E. Novembre,et al.  Gastroesophageal reflux and bronchial asthma: prevalence and effect of cisapride therapy. , 1993, Journal of pediatric gastroenterology and nutrition.

[11]  S. O'connell,et al.  Most asthmatics have gastroesophageal reflux with or without bronchodilator therapy. , 1990, Gastroenterology.

[12]  S. Sontag.  The medical management of reflux esophagitis. Role of antacids and acid inhibition. , 1990, Gastroenterology clinics of North America.

[13]  R. Ballard,et al.  Effects of spontaneous and simulated gastroesophageal reflux on sleeping asthmatics. , 1990, The American review of respiratory disease.

[14]  T. Ekström,et al.  Gastro-oesophageal reflux and triggering of bronchial asthma: a negative report. , 1987, European journal of respiratory diseases.

[15]  Phillips Yy,et al.  Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, November 1986. , 1987, The American review of respiratory disease.

[16]  M. Grunstein,et al.  Respiratory response to intraesophageal acid infusion in asthmatic children during sleep. , 1983, The Journal of allergy and clinical immunology.

[17]  H. Levison,et al.  Gastroesophageal reflux during sleep in asthmatic patients. , 1983, The Journal of pediatrics.

[18]  W A Zin,et al.  A simple method for assessing the validity of the esophageal balloon technique. , 2015, The American review of respiratory disease.

[19]  L. Mansfield,et al.  Further investigation of the association between gastroesophageal reflux and bronchoconstriction. , 1982, The Journal of allergy and clinical immunology.

[20]  M. Grunstein,et al.  The relationship of gastroesophageal reflux to nocturnal wheezing in children with asthma. , 1982, Annals of allergy.

[21]  E. Wolpert.  A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. , 1969 .

[22]  B. Ferris,et al.  The mechanical behavior of the lungs in healthy elderly persons. , 1957, The Journal of clinical investigation.