The role of gastroesophageal reflux disease in asthma
ABSTRACT Purpose: To emphasize the relationship between gastroesophageal reflux disease (GERD) and asthma symptoms or exacerbations.Data sources: Selective review of the scientific literature.Conclusions: Although studies in recent years have offered insight into the relationship between GERD and asthma symptoms, many nurse practitioners (NPs) fail to recognize atypical GERD symptoms, which may explain difficult-to-treat asthma and exacerbation. It has become evident that patients suffering from persistent asthma display an increased prevalence of GERD.Implications for practice: While there are increasing constraints that limit the provider–patient interaction time, it is imperative that NPs develop keen assessment skills to effectively diagnose and treat asthma symptoms that are a product of GERD. Awareness of the asthma–GERD relationship allows NPs to quickly obtain pertinent information and successfully determine how to efficiently treat symptomatic asthmatic patients.
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ABSTRACT: Asthma and gastroesophageal reflux disease (GERD) often coexist. However, the results of the studies investigating the prevalence of GERD among patients with asthma vary greatly. To investigate the prevalence of GERD in adult patients with asthma. The basic study population consisted of 2,225 asthmatic patients who were treated in six specialist-headed hospitals during 1 year. From the common computer-based discharge register, every 14th patient was randomly selected for the study. Ninety of the 149 contacted patients (60%) agreed to participate in the study. Twenty-four-hour esophageal pH monitoring was performed on all patients. GERD was found in 32 of the patients (36%). Eight of these patients (25%) were free from classical reflux symptoms. Forty-seven of the 90 patients (52%) presented with typical reflux symptoms. Twenty-four of these patients (51%) were found to have abnormal acidic reflux. According to the current study, one third of adult patients with asthma have GERD. These patients often do not have typical reflux symptoms. However, the presence of typical reflux symptoms in an asthmatic patient does not seem to guarantee the presence of abnormal acidic reflux.Chest 11/2004; 126(5):1490-4. · 5.85 Impact Factor
Article: Gastro-oesophageal reflux disease.BMJ (Clinical research ed.). 02/2006; 332(7533):88-93.
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ABSTRACT: To study the role of autonomic regulation in asthmatics with gastroesophageal reflux (GER). Prospective study. Autonomic function laboratory of a 908-bed university hospital. Fifteen nonsmoking asthmatics with GER (six men, nine women; average age, 36 years). Subjects were connected to an ECG monitor. BP was measured by sphygmomanometer at set intervals. After a resting period, each subject had heart rate and BP monitored during an 80 degrees passive tilt, Valsalva maneuver, quiet and deep breathing, handgrip, and an echo stress test of cortical arousal. Each autonomic function test was analyzed and defined as normal, hypervagal, hyperadrenergic, or mixed (a combination of hypervagal and hyperadrenergic responses) as compared with 23 age-matched normal control subjects from our laboratory (14 men, 9 women; average age, 35 years) and published normal control values. Each subject had an overall response score that was determined by the results of the tilt, Valsalva maneuver, and deep breathing maneuvers. All asthmatics with reflux had at least one autonomic function test display a hypervagal response. Overall response scores show that eight of 15 asthmatics with GER had an overall hypervagal response, and seven had a mixed response. Of the seven asthmatics with GER who had a mixed response score, two had a hypervagal predominant response. Asthmatics with GER have evidence of autonomic dysfunction. Heightened vagal tone may be partially responsible for the heightened airway responsiveness to esophageal acidification in asthmatics with reflux.Chest 02/1997; 111(1):65-70. · 5.85 Impact Factor