Gastroesophageal reflux disease and childhood asthma

Abstract

Current evidence does not support the routine use of anti-GERD medications in the treatment of poorly controlled asthma of childhood. However large controlled trials of children symptomatic of both GERD and asthma have not been conducted, and in this case the benefits of treatment, although unproven, might outweigh the risks.

Gastroesophageal reflux and lung disease

“…Reflux is common in infants, and aspiration of refluxed gastric contents into the lungs can occur [1,2]. Reflux may cause an exacerbation of asthma or be a cause of recurrent pneumonia or vocal cord dysfunction.…”

“…GER has been linked to chronic cough, vocal cord dysfunction and lower respiratory tract airway disorders [1][2][3][4][5]. GER can precipitate cough directly via microaspiration or indirectly by activating an esophageobronchial reflex or by increasing the sensitivity of the cough reflex (both mediated by the vagus nerve).…”

Gastroesophageal Reflux

“…There is no association between asthma control status and laryngo-pharyngeal reflux and GER [68]. Current evidence does not support the routine use of anti-GERD medication in the treatment of poorly controlled asthma of childhood [69].…”

Tissue Optical Clearing, Three-Dimensional Imaging, and Computer Morphometry in Whole Mouse Lungs and Human Airways

“…We also detected new pleural nerve connectivity to vessels and airways, derivation from airways, wrapping around from dorsal to ventral surfaces. Our method also found novel connections between the distal esophagus and inferior lungs via the mediastinal fascia that may relate to the association between airway disease (e.g., asthma and cough) and esophageal disease (e.g., eosinophilic esophagitis, reflux) (25)(26)(27)(28)(29)(30). The inability to image the whole lung and esophagus in prior studies likely led to undersampling, which explains differing conclusions about the distribution of visceral pleural nerves seen in these previous studies (23,24,31).…”