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Cochrane Database Syst Rev. 2003;(2):CD001496.

Gastro-oesophageal reflux treatment for asthma in adults and children.

Author information

1
Department of Respiratory and Sleep Medicine, John Hunter Hospital, Locked Bag 1, Hunter Mail Centre, NSW, Australia. mdpgg@mail.newcastle.edu.au

Abstract

BACKGROUND:

Asthma and gastro-oesophageal reflux are both common medical conditions and often co-exist. Studies have shown conflicting results concerning the effects of lower oesophageal acidification as a trigger of asthma. Furthermore, asthma might precipitate gastro-oesophageal reflux. Thus a temporal association between the two does not establish that gastro-oesophageal reflux triggers asthma. Randomised trials of a number of treatments for gastro-oesophageal reflux in asthma have been conducted to determine whether treatment of reflux improves asthma.

OBJECTIVES:

The objective of this review was to evaluate the effectiveness of treatments for gastro-oesophageal reflux in terms of their benefit on asthma.

SEARCH STRATEGY:

The Cochrane Airways Group trials register, review articles and reference lists of articles were searched.

SELECTION CRITERIA:

Randomised controlled trials of treatment for oesophageal reflux in adults and children with a diagnosis of both asthma and gastro-oesophageal reflux.

DATA COLLECTION AND ANALYSIS:

Trial quality and data extraction were carried out by two independent reviewers. Authors were contacted for confirmation or more data.

MAIN RESULTS:

Twelve trials met the inclusion criteria. Interventions included proton pump inhibitors (n=6), histamine antagonists (n=5), surgery (n=1) and conservative management (n=1). Treatment duration ranged from 1 week to 6 months. A temporal association between asthma and gastro-oesophageal reflux was investigated in 4 trials and found to be present in a proportion of participants in these trials. Anti-reflux treatment did not consistently improve lung function, asthma symptoms, nocturnal asthma or the use of asthma medications.

REVIEWER'S CONCLUSIONS:

In asthmatic subjects with gastro-oesophageal reflux, (but who were not recruited specifically on the basis of reflux-associated respiratory symptoms), there was no overall improvement in asthma following treatment for gastro-oesophageal reflux. Subgroups of patients may gain benefit, but it appears difficult to predict responders.

PMID:
12804410
DOI:
10.1002/14651858.CD001496
[Indexed for MEDLINE]

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