• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of gutGutCurrent TOCInstructions to authors
Gut. Jul 1992; 33(7): 872–876.
PMCID: PMC1379396

Prevalence of oesophagitis in asthmatics.

Abstract

The exact relation between gastro-oesophageal reflux and asthma remains poorly understood. To determine whether gastro-oesophageal reflux in asthmatics results in oesophagitis, endoscopy and oesophageal biopsy were performed on 186 consecutive adult asthmatics. The presence or absence of reflux symptoms was not used as a selection criterion for asthmatics. Endoscopy was performed by two endoscopists using predefined criteria. All asthmatics had discrete wheezing and either a previous diagnosis of asthma or documented reversible airways obstruction of at least 20%. The oesophageal mucosa was graded as normal if no erosions or ulcerations were present in the tubular oesophagus; as oesophagitis if a mucosal break with exudate (erosions and/or ulcerations) was present; and as Barrett's if specialised (intestinal) columnar epithelium was present. A hiatal hernia was diagnosed if greater than or equal to 2 cm of gastric mucosa appeared above the diaphragm during endoscopy. Thirty nine per cent of the patients with asthma had oesophagitis or Barrett's oesophagus, or both. There was no difference in the oesophageal mucosal status between asthmatics who required and those who did not require bronchodilators. Fifty eight per cent of asthmatics had a hiatal hernia. It is concluded that oesophagitis is common and independent of the use of bronchodilator therapy in asthmatics.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.0M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Mays EE. Intrinsic asthma in adults. Association with gastroesophageal reflux. JAMA. 1976 Dec 6;236(23):2626–2628. [PubMed]
  • Friedland GW, Yamate M, Marinkovich VA. Hiatal hernia and chronic unremitting asthma. Pediatr Radiol. 1973 Oct;1(3):156–160. [PubMed]
  • Babb RR, Notarangelo J, Smith VM. Wheezing: a clue to gastroesophageal reflux. Am J Gastroenterol. 1970 Mar;53(3):230–233. [PubMed]
  • Klotz SD, Moeller RK. Hiatal hernia and intractable bronchial asthma. Ann Allergy. 1971 Jun;29(6):325–328. [PubMed]
  • Overholt RH, Ashraf MM. Esophageal reflux as trigger in asthma. N Y State J Med. 1966 Dec 1;66(23):3030–3032. [PubMed]
  • CLEMENCON GH, OSTERMAN PO. Hiatal hernia in bronchial asthma: the importance of concomitant pulmonary emphysema. Gastroenterologia. 1961;95:110–120. [PubMed]
  • Bretza J, Novey HS. Gastroesophageal reflux and asthma. West J Med. 1979 Oct;131(4):320–320. [PMC free article] [PubMed]
  • Lomasney TL. Hiatus hernia and the respiratory tract. Ann Thorac Surg. 1977 Nov;24(5):448–450. [PubMed]
  • Mansfield LE, Stein MR. Gastroesophageal reflux and asthma: a possible reflex mechanism. Ann Allergy. 1978 Oct;41(4):224–226. [PubMed]
  • Mays EE, Dubois JJ, Hamilton GB. Pulmonary fibrosis associated with tracheobronchial aspiration. A study of the frequency of hiatal hernia and gastroesophageal reflux in interstitial pulmonary fibrosis of obscure etiology. Chest. 1976 Apr;69(4):512–515. [PubMed]
  • Orringer MB. Respiratory symptoms and esophageal reflux. Chest. 1979 Dec;76(6):618–619. [PubMed]
  • Sontag SJ, O'Connell S, Khandelwal S, Miller T, Nemchausky B, Schnell TG, Serlovsky R. Most asthmatics have gastroesophageal reflux with or without bronchodilator therapy. Gastroenterology. 1990 Sep;99(3):613–620. [PubMed]
  • Permutt S. What should we measure to evaluate broncodilator drug response? Chest. 1978 Jun;73(6 Suppl):944–948. [PubMed]
  • Hetzel DJ, Dent J, Reed WD, Narielvala FM, Mackinnon M, McCarthy JH, Mitchell B, Beveridge BR, Laurence BH, Gibson GG, et al. Healing and relapse of severe peptic esophagitis after treatment with omeprazole. Gastroenterology. 1988 Oct;95(4):903–912. [PubMed]
  • Ducoloné A, Vandevenne A, Jouin H, Grob JC, Coumaros D, Meyer C, Burghard G, Methlin G, Hollender L. Gastroesophageal reflux in patients with asthma and chronic bronchitis. Am Rev Respir Dis. 1987 Feb;135(2):327–332. [PubMed]
  • Mansfield LE, Hameister HH, Spaulding HS, Smith NJ, Glab N. The role of the vague nerve in airway narrowing caused by intraesophageal hydrochloric acid provocation and esophageal distention. Ann Allergy. 1981 Dec;47(6):431–434. [PubMed]
  • Harper PC, Bergner A, Kaye MD. Antireflux treatment for asthma. Improvement in patients with associated gastroesophageal reflux. Arch Intern Med. 1987 Jan;147(1):56–60. [PubMed]
  • Kjellén G, Tibbling L, Wranne B. Bronchial obstruction after oesophageal acid perfusion in asthmatics. Clin Physiol. 1981 Jun;1(3):285–292. [PubMed]
  • Spaulding HS, Jr, Mansfield LE, Stein MR, Sellner JC, Gremillion DE. Further investigation of the association between gastroesophageal reflux and bronchoconstriction. J Allergy Clin Immunol. 1982 Jun;69(6):516–521. [PubMed]
  • Perpiñ M, Pellicer C, Marco V, Maldonado J, Ponce J. The significance of the reflex bronchoconstriction provoked by gastroesophageal reflux in bronchial asthma. Eur J Respir Dis. 1985 Feb;66(2):91–97. [PubMed]
  • Andersen LI, Schmidt A, Bundgaard A. Pulmonary function and acid application in the esophagus. Chest. 1986 Sep;90(3):358–363. [PubMed]
  • Pellegrini CA, DeMeester TR, Johnson LF, Skinner DB. Gastroesophageal reflux and pulmonary aspiration: incidence, functional abnormality, and results of surgical therapy. Surgery. 1979 Jul;86(1):110–119. [PubMed]
  • Veyrac M, Bories P, Collet H, Parelon G, Fauroux P, Godard P, Michel H. Scintigraphie et pHmétrie oesophagienne chez des adultes asthmatiques suspects de reflux gastro-oesophagien. Gastroenterol Clin Biol. 1986 May;10(5):400–404. [PubMed]
  • Overholt RH, Ashraf MM. Esophageal reflux as trigger in asthma. N Y State J Med. 1966 Dec 1;66(23):3030–3032. [PubMed]
  • Lomasney TL. Hiatus hernia and the respiratory tract. Ann Thorac Surg. 1977 Nov;24(5):448–450. [PubMed]
  • Urschel HC, Jr, Paulson DL. Gastroesophageal reflux and hiatal hernia. Complications and therapy. J Thorac Cardiovasc Surg. 1967 Jan;53(1):21–32. [PubMed]
  • Stein MR, Towner TG, Weber RW, Mansfield LE, Jacobson KW, McDonnell JT, Nelson HS. The effect of theophylline on the lower esophageal sphincter pressure. Ann Allergy. 1980 Oct;45(4):238–241. [PubMed]
  • Bengtsson U, Sandberg N, Bake B, Löwhagen O, Svedmyr N, Månsson I, Carlsson S. Gastro-oesophageal reflux and night-time asthma. Lancet. 1985 Jun 29;1(8444):1501–1502. [PubMed]
  • Allen CJ, Newhouse MT. Gastroesophageal reflux and chronic respiratory disease. Am Rev Respir Dis. 1984 Apr;129(4):645–647. [PubMed]
  • Shapiro GG, Christie DL. Gastroesophageal reflux in steroid-dependent asthmatic youths. Pediatrics. 1979 Feb;63(2):207–212. [PubMed]
  • DiMarino AJ, Jr, Cohen S. Effect of an oral beta2-adrenergic agonist on lower esophageal sphincter pressure in normals and in patients with achalasia. Dig Dis Sci. 1982 Dec;27(12):1063–1066. [PubMed]
  • Zfass AM, Prince R, Allen FN, Farrar JT. Inhibitory beta adrenergic receptors in the human distal esophagus. Am J Dig Dis. 1970 Apr;15(4):303–310. [PubMed]
  • Berquist WE, Rachelefsky GS, Rowshan N, Siegel S, Katz R, Welch M. Quantitative gastroesophageal reflux and pulmonary function in asthmatic children and normal adults receiving placebo, theophylline, and metaproterenol sulfate therapy. J Allergy Clin Immunol. 1984 Feb;73(2):253–258. [PubMed]
  • Hubert D, Gaudric M, Guerre J, Lockhart A, Marsac J. Effect of theophylline on gastroesophageal reflux in patients with asthma. J Allergy Clin Immunol. 1988 Jun;81(6):1168–1174. [PubMed]
  • Feinstein AR. On blind men, elephants, spectrums, and controversies: lessons from rheumatic fever revisited. J Chronic Dis. 1986;39(5):337–342. [PubMed]
  • Miller TQ, Turner CW, Tindale RS, Posavac EJ. Disease based spectrum bias in referred samples and the relationship between type A behavior and coronary artery disease. J Clin Epidemiol. 1988;41(12):1139–1149. [PubMed]
  • Philbrick JT, Horwitz RI, Feinstein AR, Langou RA, Chandler JP. The limited spectrum of patients studied in exercise test research. Analyzing the tip of the iceberg. JAMA. 1982 Nov 19;248(19):2467–2470. [PubMed]
  • Ransohoff DF, Feinstein AR. Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. N Engl J Med. 1978 Oct 26;299(17):926–930. [PubMed]

Articles from Gut are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...