The effect of treatment for gastro-esophageal reflux on asthma in adults and children

There is probably no overall improvement of asthma following treatment of gastro-oesophageal reflux. Subgroups of patients may gain benefit, but it appears difficult to predict responders.

Nine trials were included in a Cochrane review . Interventions included proton-pump inhibitors (3), histamine H2-receptor antagonists (5), surgery (1) and conservative management (1). Anti-reflux treatment did not consistently improve lung function, asthma symptoms (2 of 9 studies suggested a beneficial effect), nocturnal asthma or the use of asthma medication.

Another systematic review including 12 RCTs with a total of 325 subjects was abstracted in DARE. 8 RCTs were placebo-controlled (n=199). Comparison of the different studies was difficult because of diversity of design. Studies were performed over a 15 year period, and treatments changed over years. In the studies with acceptable quality (199 patients) the number of studies with improvement/with no improvent was 3/4 for asthma symptoms, 2/4 for asthma medication use, 2/5 for spirometry, 0/6 for PEF.

Comment: The quality of evidence is downgraded by inconsistency of results.

Ədəbiyyat

1. Gibson PG, Henry RL, Coughlan JL. Gastro-oesophageal reflux treatment for asthma in adults and children. Cochrane Database Syst Rev 2003;(2):CD001496.
2. Field SK, Sutherland LR. Does medical antireflux therapy improve asthma in asthmatics with gastroesophageal reflux?: a critical review of the literature. Chest 1998 Jul;114(1):275-83.