Asthma and gastroesophageal reflux disease in children: Exploring the relationship

Gold, Benjamin D.

doi:10.1016/j.jpeds.2004.11.036

Cited by 41 publications

(22 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Através de pHmetria esofágica de 24 horas, observou-se ausência de DRGE em pacientes com asma intermitente, ao passo que naqueles com as formas persistentes leve, moderada e grave, a pHmetria estava alterada em 11%, 23% e 57%, respectivamente. Ademais, um ou mais sintomas de DRGE estava presente em 53% dos pacientes com refluxo e em 13% dos pacientes sem refluxo, enquanto que a endoscopia digestiva revelou esofagite em 44% dos pacientes com pHmetria alterada e em 9% dos pacientes sem pHmetria alterada 47 .…”

Section: Asmaunclassified

“…O mesmo pode ser considerado nos casos de lactentes que sibilam ou tossem durante ou após a alimentação. Assim, deve ser realizada terapia de inibição ácida com IBP por 3 meses em doses mais altas do que as habitualmente preconizadas 47 . Alguns autores acreditam que a melhora dos sintomas respiratórios é tardia em relação aos outros sintomas da DRGE, demorando de 2 a 3 meses para ocorrer.…”

Section: Asmaunclassified

See 1 more Smart Citation

Treatment of gastroesophageal reflux disease

Guimarães¹,

Marguet²,

Camargos³

2006

J Pediatr (Rio J)

View full text Add to dashboard Cite

Objective: To review the literature on the treatment of gastroesophageal reflux disease (GERD) with emphasis on pharmacological aspects. To identify particularities of pharmacological treatment of esophageal and extraesophageal manifestations of the disease.Sources: Electronic search of the PubMed/MEDLINE and Cochrane Collaboration databases. Controlled and randomized studies published since 2000 and reviews representing consensus positions and directives published within the last 10 years were identified. Summary of the findings:The drugs currently available for the treatment of GERD do not act in the primary mechanism of the disease, i.e., transitory relaxation of the lower esophageal sphincter. Pharmacological treatment of GERD with symptoms or with esophageal injury is based on the suppression of acid secretion, particularly with proton pump inhibitors. When the hyperreactivity of the lower airways coexists with esophageal GERD symptoms, suppression of acid secretions should be of benefit in managing the respiratory disease in the presence of a causal relationship; however, this is not usual. When esophageal symptoms are not present, esophageal 24-hour pH study should be carried out prior to starting pharmacological treatment for GERD. Improvement of respiratory symptoms may be delayed with relation to esophageal symptoms. It is common for GERD to recur and pharmacological treatment should be repeated or continued indefinitely, depending on clinical presentation of the disease. Conclusions:The strategies that have been proposed for the pharmacological treatment of GERD in children are primarily based on studies of case series or on studies with adults. There have been very few controlled and randomized studies in children. Undertaking a greater number of these studies might reinforce existing aspects or establish new aspects of management.J Pediatr (Rio J). 2006;82(5 Suppl):S133-45: Gastroesophageal reflux, child, drug therapy, esophagitis, respiratory tract diseases, asthma. ResumoObjetivo: Rever a literatura sobre tratamento da doença do refluxo gastroesofágico (DRGE) com ênfase nos aspectos farmacológi-cos. Identificar particularidades do tratamento farmacológico nas manifestações esofágicas e extra-esofágicas da doença.Fontes de dados: Busca eletrônica na base de dados PubMed/ MEDLINE e Cochrane Collaboration. Procurou-se identificar estudos controlados e randomizados publicados a partir de 2000, bem como revisões que representassem consensos e diretrizes publicados nos últimos 10 anos.Síntese dos dados: Nenhuma das drogas atualmente usadas no tratamento da DRGE altera comprovadamente o mecanismo principal da doença, ou seja, os relaxamentos transitórios do esfíncter esofágico inferior. O tratamento farmacológico da DRGE com sintomas ou com lesões esofágicas é baseado na inibição da secreção ácida, em particular pelos inibidores da bomba de prótons (IBP). Nas situações em que a hiper-reatividade das vias aéreas inferiores coexiste com sintomas esofágicos da DRGE, a inibição da secreção ácida deve...

show abstract

Section: Asmaunclassified

Treatment of gastroesophageal reflux disease

Guimarães¹,

Marguet²,

Camargos³

2006

J Pediatr (Rio J)

View full text Add to dashboard Cite

show abstract

“…Moreover, one or more GERD symptoms was present in 53% of patients with reflux and 13% of the patients without reflux, while digestive endoscopy revealed esophagitis in 44% of patients with abnornal pH study and in 9% of patients with normal pH study. 47 One large study compared the prevalence of respiratory manifestations in neurologically normal children hospitalized with a diagnosis of GERD against that of children without a GERD diagnosis. These manifestations were twice as frequent in children with reflux compared with children without reflux.…”

Section: Asthmamentioning

confidence: 99%

“…Therefore, acid suppression therapy should be started using PPI for 3 months at higher doses than normally prescribed. 47 Some authors believe that respiratory symptoms improve later than other symptoms of GERD, taking from 2 to 3 months to respond. It may be necessary to divide the acid-suppression dose into two to control nocturnal symptoms, with the second portion taken after the evening meal.…”

Section: Asthmamentioning

confidence: 99%

See 1 more Smart Citation

Tratamento da doença do refluxo gastroesofágico

Guimarães

Marguet

Camargos

2006

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objective: To review the literature on the treatment of gastroesophageal reflux disease (GERD) with emphasis on pharmacological aspects. To identify particularities of pharmacological treatment of esophageal and extraesophageal manifestations of the disease.Sources: Electronic search of the PubMed/MEDLINE and Cochrane Collaboration databases. Controlled and randomized studies published since 2000 and reviews representing consensus positions and directives published within the last 10 years were identified. Summary of the findings:The drugs currently available for the treatment of GERD do not act in the primary mechanism of the disease, i.e., transitory relaxation of the lower esophageal sphincter. Pharmacological treatment of GERD with symptoms or with esophageal injury is based on the suppression of acid secretion, particularly with proton pump inhibitors. When the hyperreactivity of the lower airways coexists with esophageal GERD symptoms, suppression of acid secretions should be of benefit in managing the respiratory disease in the presence of a causal relationship; however, this is not usual. When esophageal symptoms are not present, esophageal 24-hour pH study should be carried out prior to starting pharmacological treatment for GERD. Improvement of respiratory symptoms may be delayed with relation to esophageal symptoms. It is common for GERD to recur and pharmacological treatment should be repeated or continued indefinitely, depending on clinical presentation of the disease. Conclusions:The strategies that have been proposed for the pharmacological treatment of GERD in children are primarily based on studies of case series or on studies with adults. There have been very few controlled and randomized studies in children. Undertaking a greater number of these studies might reinforce existing aspects or establish new aspects of management.J Pediatr (Rio J). 2006;82(5 Suppl):S133-45: Gastroesophageal reflux, child, drug therapy, esophagitis, respiratory tract diseases, asthma. The symptoms of GERD are less common than the symptoms of GER, but, even so, are very prevalent. A prevalence study reported weekly heartburn sensation and acid regurgitation in approximately 2% of children aged 3 to 9 years and in 5% to 8% of 10 to 17 year-olds. REVIEW ARTICLEHeartburn alone was identified in 17.8% of the children in the older age group. 7 In the Western world, the prevalence of GERD among adults has been estimated from 10% to 20%. 5The refluxate may be exclusively acidic or mixed with duodenum-gastric reflux. Acid reflux is easier to identify and consequently the pathophysiology, diagnosis and treatment are better known. The bile reflux is little understood, but it has been related to severe esophagitis. 8 The case of mixed reflux diagnosis is highly problematic, and is one of the limitations of pH studies. There are no specific clinical trials on mixed reflux in the literature. has not specified the classification by age group, and most of the definitions proposed are applicable to adult patients. Notwithstan...

show abstract

Prevalence and impact of gastroesophageal reflux in adolescents with asthma: A population‐based study

Debley

Carter

Redding

2006

Pediatric Pulmonology

View full text Add to dashboard Cite

We determined the prevalence of gastroesophageal reflux disease (GERD) symptoms and the associations between GERD symptoms and asthma morbidity in a population of adolescents with asthma. Two thousand, three hundred and ninety-seven students attending six middle schools in Seattle completed the International Study of Asthma and Allergy in Children (ISAAC) written and video survey that included additional questions pertaining to GERD symptoms and asthma morbidity. Based on their responses, children were categorized as having undiagnosed current asthma, physician-diagnosed current asthma, or no asthma symptoms. The prevalence of GERD symptoms occurring at least weekly or daily was determined for each group. The asthma morbidity outcomes were emergency department visits, physician visits, missed school days, and use of inhaled medications for respiratory symptoms within the past year. Associations between GERD symptoms and asthma morbidity outcomes were determined using logistic regression. The prevalence of GERD symptoms was significantly higher among students with current asthma (19.3%; 95% confidence interval (CI), 14.9-24.2) than students with no asthma symptoms (2.5%; 95% CI, 1.8-3.4). In children with current asthma (n = 296), symptoms of GERD that occurred at least weekly were strongly associated with emergency department visits (odds ratio (OR), 5.0; 95% CI, 2.6-9.6), physician visits (OR, 2.5; 95% CI, 1.3-4.6), missed school (OR, 2.0; 95% CI, 1.1-3.7), and inhaled medication use (OR, 2.5; 95% CI, 1.3-4.7). The associations between GERD symptoms and emergency department visits, physician visits, and inhaled medication use were stronger among children with asthma who reported daily GERD symptoms (n = 14) than among children reporting weekly GERD symptoms (n = 57). The prevalence of GERD symptoms was greater in adolescents with current asthma than in those without asthma. In addition, the presence of at least weekly GERD symptoms was strongly associated with greater asthma morbidity and the use of asthma medications.

show abstract

Asthma and gastroesophageal reflux disease in children: Exploring the relationship

Cited by 41 publications

References 57 publications

Treatment of gastroesophageal reflux disease

Treatment of gastroesophageal reflux disease

Tratamento da doença do refluxo gastroesofágico

Prevalence and impact of gastroesophageal reflux in adolescents with asthma: A population‐based study

Contact Info

Product

Resources

About