Clinical Features of Asthma in Children Differ with Regard to the Intensity of Distal Gastroesophageal Acid Reflux

Kwiecień, Jarosław; Machura, Edyta; Halkiewicz, Franciszek; Karpe, Jacek

doi:10.3109/02770903.2011.561513

Cited by 13 publications

(5 citation statements)

References 25 publications

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“…Children with difficult-to-treat asthma and GERD made up to 49% of the studied patient group. Kwiecien et al 2011 found that the intensity of GER was significantly correlated with severity and the difficulty-to-control asthma attacks in asthmatic children [20]. Their finding can explain the high prevalence of GERD in the current study.…”

Section: Discussionmentioning

confidence: 51%

Induced Sputum Substance P in Children with Difficult-to-Treat Bronchial Asthma and Gastroesophageal Reflux: Effect of Esomeprazole Therapy

Bediwy

Elkholy

Al‐Biltagi

et al. 2011

International Journal of Pediatrics

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Objectives. To assess the induced sputum substance P (ISSP) levels in children having difficult-to-treat asthma (DA) with and without gastroesophageal reflux (GER). We aimed also to evaluate the association of GER with childhood DA, relationship of GER severity with childhood asthma control test (C-ACT), FEV1, peak expiratory flow (PEF) variability, and ISSP. Finally, we tried to evaluate esomeprazole treatment effect on C-ACT and FEV1 in children with DA. Methods. Spirometry, C-ACT, upper gastrointestinal endoscopy, and ISSP measurement were done for children with DA compared to healthy controls. Results. ISSP was high in DA with higher levels in the group having associated GER. In the latter group, ISSP and C-ACT improved significantly after esomeprazole treatment while FEV1 and PEF variability did not improve. Reflux severity was positively correlated with ISSP and negatively correlated with FEV1. Conclusions. GER was found in 49% of our patients with childhood DA. Very high ISSP levels in children with DA may be used as a marker for presence of GERD. Esomeprazole therapy improved asthma symptoms but did not improve lung function.

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Section: Discussionmentioning

confidence: 51%

Induced Sputum Substance P in Children with Difficult-to-Treat Bronchial Asthma and Gastroesophageal Reflux: Effect of Esomeprazole Therapy

Bediwy

Elkholy

Al‐Biltagi

et al. 2011

International Journal of Pediatrics

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“…In adults with poor asthma control, abnormal distal or proximal esophageal pH was associated with oral steroid use, and proximal reflux was associated with worse quality of life, but neither was associated with FEV 1 , asthma control, or methacholine challenge (38). By contrast, Kwiecien et al noted that in 66 children with asthma with a mean age 10 years, night asthma symptoms were associated with a longer time spent at night with an esophageal pH below 4 (39). …”

Section: Gerd and Asthmamentioning

confidence: 99%

Aspiration Risk and Respiratory Complications in Patients with Esophageal Atresia

Kovesi

2017

Front. Pediatr.

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Chronic, long-term respiratory morbidity (CRM) is common in patients with a history of repaired congenital esophageal atresia, typically associated with tracheoesophageal fistula (EA/TEF). EA/TEF patients are at high risk of having aspiration, and retrospective studies have associated CRM with both recurrent aspiration and atopy. However, studies evaluating the association between CRM in this population and either aspiration or atopy have reported conflicting results. Furthermore, CRM in this population may be due to other related conditions as well, such as tracheomalacia and/or recurrent infections. Aspiration is difficult to confirm, short of lung biopsy. Moreover, even within the largest evidence base assessing the association between CRM and aspiration, which has evaluated the potential relationship between gastroesophageal reflux and asthma, findings are contradictory. Studies attempting to relate CRM to prior aspiration events may inadequately estimate the frequency and severity of previous aspiration episodes. There is convincing evidence documenting that chronic, massive aspiration in patients with repaired EA/TEF is associated with the development of bronchiectasis. While chronic aspiration is likely associated with other CRM in patients with repaired EA/TEF, this does not appear to have been confirmed by the data currently available. Prospective studies that systematically evaluate aspiration risk and allergic disease in patients with repaired EA/TEF and document subsequent CRM will be needed to clarify the causes of CRM in this population. Given the prevalence of CRM, patients with repaired EA/TEF should ideally receive regular follow-up by multidisciplinary teams with expertise in this condition, throughout both childhood and adulthood.

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“…However, in spite of the reported association between the two clinical entities, this does not imply causality, and an important controversy still persists regarding this topic. For example, the presence of GERD does not seem to have a significant impact on pulmonary function parameters, and recent studies recognise little to no significant clinical improvement after PPI therapy in bronchial asthma patients with concomitant GERD [ 22 , 23 , 24 ].…”

Section: Pepsin Detection In Bronchial Asthmamentioning

confidence: 99%

Pepsin and the Lung—Exploring the Relationship between Micro-Aspiration and Respiratory Manifestations of Gastroesophageal Reflux Disease

Iov

Bărboi

Floria

et al. 2022

JPM

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Gastroesophageal reflux disease (GERD) is one of the most commonly encountered disorders in clinical practice nowadays, with an increasing burden on healthcare systems worldwide. GERD-related respiratory symptoms such as unexplained chronic cough, bronchial asthma or chronic obstructive pulmonary disease (COPD) with frequent exacerbations often pose diagnostic and therapeutic challenges and may require a multidisciplinary approach. Moreover, a potential role of GERD as a risk factor has been proposed for chronic rejection in patients who underwent lung transplantation. Pepsin has gained considerable attention from the scientific community in the last few years as a possible surrogate biomarker for GERD. The aim of this narrative review was to provide an overview of the potential utility of pepsin detection as a marker of micro-aspiration in various biological fluids retrieved from patients with suspected GERD-induced respiratory manifestations and in lung transplant patients with allograft dysfunction. Data on the subject remains highly contradictory, and while certain studies support its applicability in investigating atypical GERD manifestations, at the moment, it would be realistic to accept a modest utility at best. A major lack of consensus persists regarding topics such as the optimal timeframe for fluid collection and cut-off values. Further research is warranted in order to address these issues.

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Clinical Features of Asthma in Children Differ with Regard to the Intensity of Distal Gastroesophageal Acid Reflux

Cited by 13 publications

References 25 publications

Induced Sputum Substance P in Children with Difficult-to-Treat Bronchial Asthma and Gastroesophageal Reflux: Effect of Esomeprazole Therapy

Induced Sputum Substance P in Children with Difficult-to-Treat Bronchial Asthma and Gastroesophageal Reflux: Effect of Esomeprazole Therapy

Aspiration Risk and Respiratory Complications in Patients with Esophageal Atresia

Pepsin and the Lung—Exploring the Relationship between Micro-Aspiration and Respiratory Manifestations of Gastroesophageal Reflux Disease

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