Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1985 Aug;40(8):592–597. doi: 10.1136/thx.40.8.592

Gastro-oesophageal reflux and childhood asthma: the acid test.

N M Wilson, L Charette, A H Thomson, M Silverman
PMCID: PMC1020597  PMID: 4035629

Abstract

The presence of gastro-oesophageal reflux was investigated in 18 children with moderate to severe asthma by overnight oesophageal pH monitoring. Appreciable reflux was found during sleep in eight; its relevance to nocturnal asthma was not clear. On another occasion the same children were challenged in a double blind fashion with a drink of dilute hydrochloric acid (0.001 N) and the response of the airways was monitored by peak flow measurements and by histamine challenge tests. There was a significant increase in mean histamine sensitivity (p = 0.001) 90 minutes after the acid drink without any associated change in baseline peak flow rate. Eight children had a significant response to the acid drink, and a further three reacted to a more concentrated solution (0.01 N). In those asthmatic children in whom reflux is associated with a positive response to an acid drink (five out of 18 in the present study) it seems likely that reflux exacerbates nocturnal symptoms.

Full text

PDF
592

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Babb R. R., Notarangelo J., Smith V. M. Wheezing: a clue to gastroesophageal reflux. Am J Gastroenterol. 1970 Mar;53(3):230–233. [PubMed] [Google Scholar]
  2. Barnes P. J. Nocturnal asthma: mechanisms and treatment. Br Med J (Clin Res Ed) 1984 May 12;288(6428):1397–1398. doi: 10.1136/bmj.288.6428.1397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Berquist W. E., Rachelefsky G. S., Kadden M., Siegel S. C., Katz R. M., Mickey M. R., Ament M. E. Effect of theophylline on gastroesophageal reflux in normal adults. J Allergy Clin Immunol. 1981 May;67(5):407–411. doi: 10.1016/0091-6749(81)90087-7. [DOI] [PubMed] [Google Scholar]
  4. Berquist W. E., Rachelefsky G. S., Rowshan N., Siegel S., Katz R., Welch M. Quantitative gastroesophageal reflux and pulmonary function in asthmatic children and normal adults receiving placebo, theophylline, and metaproterenol sulfate therapy. J Allergy Clin Immunol. 1984 Feb;73(2):253–258. doi: 10.1016/s0091-6749(84)80016-0. [DOI] [PubMed] [Google Scholar]
  5. Christensen J. Effects of drugs on esophageal motility. Arch Intern Med. 1976 May;136(5):532–537. [PubMed] [Google Scholar]
  6. Cockcroft D. W., Killian D. N., Mellon J. J., Hargreave F. E. Bronchial reactivity to inhaled histamine: a method and clinical survey. Clin Allergy. 1977 May;7(3):235–243. doi: 10.1111/j.1365-2222.1977.tb01448.x. [DOI] [PubMed] [Google Scholar]
  7. Davis R. S., Larsen G. L., Grunstein M. M. Respiratory response to intraesophageal acid infusion in asthmatic children during sleep. J Allergy Clin Immunol. 1983 Oct;72(4):393–398. doi: 10.1016/0091-6749(83)90505-5. [DOI] [PubMed] [Google Scholar]
  8. Foglia R. P., Fonkalsrud E. W., Ament M. E., Byrne W. J., Berquist W., Siegel S. C., Katz R. M., Rachelefsky G. S. Gastroesophageal fundoplication for the management of chronic pulmonary disease in children. Am J Surg. 1980 Jul;140(1):72–79. doi: 10.1016/0002-9610(80)90420-1. [DOI] [PubMed] [Google Scholar]
  9. Goodall R. J., Earis J. E., Cooper D. N., Bernstein A., Temple J. G. Relationship between asthma and gastro-oesophageal reflux. Thorax. 1981 Feb;36(2):116–121. doi: 10.1136/thx.36.2.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Goyal R. K., Rattan S. Mechanism of the lower esophageal sphincter relaxation. Action of prostaglandin E 1 and theophylline. J Clin Invest. 1973 Feb;52(2):337–341. doi: 10.1172/JCI107189. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hariparsad D., Wilson N., Dixon C., Silverman M. Oral tartrazine challenge in childhood asthma: effect on bronchial reactivity. Clin Allergy. 1984 Jan;14(1):81–85. doi: 10.1111/j.1365-2222.1984.tb02194.x. [DOI] [PubMed] [Google Scholar]
  12. Hughes D. M., Spier S., Rivlin J., Levison H. Gastroesophageal reflux during sleep in asthmatic patients. J Pediatr. 1983 May;102(5):666–672. doi: 10.1016/s0022-3476(83)80231-5. [DOI] [PubMed] [Google Scholar]
  13. Mansfield L. E., Hameister H. H., Spaulding H. S., Smith N. J., Glab N. The role of the vague nerve in airway narrowing caused by intraesophageal hydrochloric acid provocation and esophageal distention. Ann Allergy. 1981 Dec;47(6):431–434. [PubMed] [Google Scholar]
  14. Mays E. E. Intrinsic asthma in adults. Association with gastroesophageal reflux. JAMA. 1976 Dec 6;236(23):2626–2628. [PubMed] [Google Scholar]
  15. Overholt R. H., Ashraf M. M. Esophageal reflux as trigger in asthma. N Y State J Med. 1966 Dec 1;66(23):3030–3032. [PubMed] [Google Scholar]
  16. Pellegrini C. A., DeMeester T. R., Johnson L. F., Skinner D. B. Gastroesophageal reflux and pulmonary aspiration: incidence, functional abnormality, and results of surgical therapy. Surgery. 1979 Jul;86(1):110–119. [PubMed] [Google Scholar]
  17. Perpiñ M., Ponce J., Marco V., Benlloch E., Miralbés M., Berenguer J. The prevalence of asymptomatic gastroesophageal reflux in bronchial asthma and in non-asthmatic individuals. Eur J Respir Dis. 1983 Nov;64(8):582–587. [PubMed] [Google Scholar]
  18. Shapiro G. G., Christie D. L. Gastroesophageal reflux in steroid-dependent asthmatic youths. Pediatrics. 1979 Feb;63(2):207–212. [PubMed] [Google Scholar]
  19. Spaulding H. S., Jr, Mansfield L. E., Stein M. R., Sellner J. C., Gremillion D. E. Further investigation of the association between gastroesophageal reflux and bronchoconstriction. J Allergy Clin Immunol. 1982 Jun;69(6):516–521. doi: 10.1016/0091-6749(82)90176-2. [DOI] [PubMed] [Google Scholar]
  20. Strobel C. T., Byrne W. J., Ament M. E., Euler A. R. Correlation of esophageal lengths in children with height: application to the Tuttle test without prior esophageal manometry. J Pediatr. 1979 Jan;94(1):81–84. doi: 10.1016/s0022-3476(79)80361-3. [DOI] [PubMed] [Google Scholar]
  21. Wilson N. M., Dixon C., Silverman M. Increased bronchial responsiveness caused by ingestion of ice. Eur J Respir Dis. 1985 Jan;66(1):25–30. [PubMed] [Google Scholar]
  22. Wilson N., Vickers H., Taylor G., silverman M. Objective test for food sensitivity in asthmatic children: increased bronchial reactivity after cola drinks. Br Med J (Clin Res Ed) 1982 Apr 24;284(6324):1226–1228. doi: 10.1136/bmj.284.6324.1226. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. de VRIES, GOEI J. T., BOOY-NOORD H., ORIE N. G. Changes during 24 hours in the lung function and histamine hyperreactivity of the bronchial tree in asthmatic and bronchitic patients. Int Arch Allergy Appl Immunol. 1962;20:93–101. doi: 10.1159/000229248. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES