Asthmatics often have reflux, but don't know it

People with asthma often have gastro-esophageal reflux disease (GERD), but typical symptoms such as frequent heartburn may be absent, according to Finnish doctors.

Dr. Toni O. Kiljander and Dr. Jukka O. Laitinen from Tampere University Hospital investigated the prevalence of GERD among 90 adults selected from a database of 2225 asthmatic patients.

The team measured acidity in the esophagus to document abnormal gastric acid reflux.

They found that 32 of the participants had high esophageal acidity, but only 24 of them had symptoms that typically signal gastric acid reflux disease.

On the other hand, 47 the 90 patients said they did have typical GERD symptoms, but only half of these had acid reflux when they were monitored, the researchers report in the medical journal Chest.

"GERD is common in adult asthmatics and may be present even without heartburn and regurgitation in these patients," Kiljander told Reuters Health. "However, the presence of heartburn does not always seem to guarantee the presence of acidic reflux in these patients."

The investigator noted that asthma itself and some medicines commonly used for treating asthma may promote gastric acid reflux, "and therefore at least partly explain the high prevalence of GERD among asthmatics." So, the question of whether GERD triggers asthma "remains to be solved."

Even so, asthma patients with acid reflux may find it worthwhile to try medications that suppress stomach acid production - so-called proton pump inhibitors, such as Prevacid or Nexium, for example. "There is evidence from the previous studies that at least some asthmatics with GERD appear to benefit from proton pump inhibitor treatment," Kiljander concluded.

SOURCE: Chest, November 2004.