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Prevalence of gastro-oesophageal reflux in asthmatics: an Italian study.

BACKGROUND
Gastro-oesophageal reflux is regarded as an asthma trigger, its prevalence, in asthma, still being uncertain.


AIM
Purpose of the study was to assess the prevalence of gastro-oesophageal reflux in adult asthma patients.


PATIENTS
A series of 37 asthmatics were recruited consecutively over 6 months. Subjects were: 19 atopic (5 males; 38.0 years +/- 4.1 SE), and 18 non-atopic asthmatics (5 males; 53.2 years +/- 4.3 SE). They were well matched for sex and basal lung function, whilst mean age was appreciably higher (p < 0.007) in non-atopic asthmatics.


METHODS
Gastro-oesophageal reflux was detected by X-barium-oesophagram, endoscopy, and 24 h oesophago-gastric pH-monitoring.


RESULTS
Gastro-oesophageal reflux was assessed in 78.9% of atopic, and in 83.3% of non-atopic asthmatics; the 24 h pH-monitoring was confirmed as the most sensitive method for gastro-oesophageal reflux detection. Hiatal hernia was found in 15.8% of atopic, and in 38.9% of non-atopic subjects. Respiratory symptoms always started long before gastro-oesophageal signs in atopic patients, while digestive symptoms came first (about 6 years) in 44.4% of non-atopic asthmatics. Oral theophylline was taken daily by 10.5% of atopic, and by 22.2% of non-atopic asthmatics.


CONCLUSIONS
When non-atopic asthma starts at a later age without any family history of asthma, and/or after a long history of digestive symptoms, the role of gastro-oesophageal reflux can be strongly suspected.