Gastroesophageal Reflux Disease and Bronchial Asthma: Updated View on the Problem of Comorbidity
Journal Title: Lviv Clinical Bulletin - Year 2014, Vol 4, Issue 8
Abstract
Introduction. Recently, much attention is paid to comorbidity. It is proved that in patients with bronchial asthma (BA) gastroesophageal reflux occurs significantly more frequently than in general population (70.0–80.0 %), which naturally provokes interest to this consolidation. As early as 1892, W. Osler first described an attack of an aspiration caused by aspiration of gastric contents, initiating the study of reflux induced asthma. Scientists distinguish a number of factors that influence its occurrence: the weakness of the esophageal sphincter, the failure of induced cardia, the keel of the esophagus, the reduction of the resistance of the mucous membrane of the esophagus due to the constant irritation of the reflux, discoordination of the swallow reflex and the closure of the vocal cavity, and also the occurrence of reflux in the bronchial tree. Aim. To describe the contemporary views on the problem of comorbidity of gastroesophagal reflux disease (GERD) and BA. Materials and methods. Content analysis, method of system and comparative analysis, bibliosemantic method of the study of actual scientific research concerning the problem of comorbidity of GERD and BA was used. Results. Lung function testing results analysis performed in our study, showed that patients with both BA and reflux had significantly lower values of volume parameters, whereas velocity parameters did not significantly differ from those without reflux, suggesting more pronounced restrictive lung abnormalities in asthmatic patient with gastroesophageal reflux diseases (GERD). Besides, subjects with asthma and GERD combination were less responsive to bronchodilator therapy and therefore had worse asthma control. Despite the fact that BA combined with GERD has more severe course and poorer response to treatment, the results of study regarding efficacy of anti-reflux therapy were ambiguous. Although after such therapy the majority of patients with erosive form of GERD demonstrated both less severe asthma symptoms and lower demand in controller medications, there was no any improvement in the results of lung function testing. In patients with asymptomatic GERD the treatment had no effect on the clinical presentations and asthma control. Conclusions. There is a need for further study of causation and treatment strategy in patients with a combination of BA and gastroesophageal reflux. After all, timely diagnosis and treatment of erosive forms of GERD in such patients make it possible not only to avoid complications, but also to reduce the manifestations of asthma.
Authors and Affiliations
T. Hanych
Keywords
Related Articles
- EP ID EP255681
- DOI 10.25040/lkv2014.04.06
- Views 124
- Downloads 0
Оптимизация хирургического лечения тяжелой формы вальгусного отклонения первого пальца стопы модифицированным методом остеосинтеза
Введение. Внимание к проблеме вальгусного отклонения первого пальца стопы (ВОППС) не ослабевает около 200 лет, что обусловлено ее широким распространением среди населения (18,0-20,0%), а также недостаточной эффективность...
Optimization of Surgical Treatment of Severe Hallux Valgus by Modified Osteosynthesis Method
Introduction. Attention to the problem of Valgus deviation of the first toe (VDFT) does not weaken for about 200 years, due to its considerable population distribution (18,0-20,0%), as well as the lack of treatment effic...
Характеристика эпидемиологической ситуации с больными туберкулезом различных возрастных групп по цифровым критериям выборочной оценки с помощью компьютерно-информационной технологии
Введение. Во многих странах мира, в том числе и в Украине, эпидемиологическая ситуация с больными туберкулезом неблагоприятная и свидетельствует о росте основных эпидемиологических показателей (заболеваемость, распростра...
Myofascial Pain Syndrome – Some Aspects of Diagnosis and Treatment
Introduction. Back pain occurs in 40.0-80.0% of the population. One of the most common causes of back pain is myofascial pain syndrome. About 84.0% of the adult population has at least one episode of back pain, and 40.0-...
The Results of the Genetic Predisposition to Type 2 Diabetes Mellitus (Mitochondrial Diabetes) Determination Among Population of Prykarpattya Region According to the Indices of Carbohydrate Metabolism Evaluation
Introduction. Considering the urgent need to optimize the methods for preventing diabetes mellitus, it is important to find the methods of early diagnosis of carbohydrate metabolism disorders that precede the manifestati...