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The Role of Respiratory Drugs in Gastroesophageal Reflux

  • M. Cazzola
  • S. Centanni
  • M. G. Matera
  • R. W. Dal Negro

Abstract

Most adult asthmatics have abnormal gastroesophageal reflux manifested by increased reflux frequency, delayed acid clearance during the day and night, and diminished lower oesophageal sphincter pressure; this happens regardless of the use of bronchodilator therapy [1]. Epidemiological evidence for the association between gastroesophageal reflux and asthma suggests that, quite apart from the need for bronchodilators, about three-fourths of asthmatics have acid gastroesophageal reflux, increased frequency of reflux episodes or heartburn, and 40% have reflux oesophagitis [2].

Keywords

Lower Esophageal Sphincter Reflux Episode Nedocromil Sodium Lower Oesophageal Sphincter Tachykinin Receptor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Sontag SJ, O’Connell S, Khandelwal S, Miller T, Nemchausky B, Schnell TG, Serlovsky R (1990) Most asthmatics have gastroesophageal reflux with or without bronchodilator therapy. Gastroenterology 99:613–620PubMedGoogle Scholar
  2. 2.
    Sontag SJ (1997) Gastroesophageal reflux and asthma. Am J Med 1093:84S-90SGoogle Scholar
  3. 3.
    Sontag SJ, O’Connell S, Khandelwal S, Miller T, Nemchausky B, Schnell TG, Serlovsky R (1990) Effect of positions, eating, and bronchodilators on gastroesophageal reflux in asthmatics. Dig Dis Sci 35:849–856PubMedCrossRefGoogle Scholar
  4. 4.
    Simpson WG (1995) Gastroesophageal reflux disease and asthma. Diagnosis and management. Arch Intern Med 155:798–803CrossRefGoogle Scholar
  5. 5.
    Harding SM, Richter JE (1992) Gatroesophageal reflux disease and asthma. Semin Gastrointest Dis 3:130–150Google Scholar
  6. 6.
    Harper PC, Bergner A, Kaye MD (1987) Antireflux treatment for asthma: improvement in patients with associated gastroesophageal reflux. Arch Intern Med 147:56–60PubMedCrossRefGoogle Scholar
  7. 7.
    Homes PW, Campbell AM, Barter CE (1978) Changes of lung volumes and mechanics in asthma and normal subjects. Thorax 33:394–400CrossRefGoogle Scholar
  8. 8.
    Singh V, Jain NK (1983) Asthma as a cause for, rather than a result of, gastroesophageal reflux. J Asthma 20:241Google Scholar
  9. 9.
    Mansfield LE (1995) Associations and interactions between the esophagus and the lower respiratory tract. Pediatr Pulmonol 11(Suppl):53–54CrossRefGoogle Scholar
  10. 10.
    Dodds WJ, Dent J Hogan WJ, Helm JF, Hauser RH, Patel GK, Egide MS (1982) Mechanisms of gastroesophageal reflux in patients with reflux esophagitis. N Engl J Med 307:1547–1552PubMedCrossRefGoogle Scholar
  11. 11.
    Richards WG, Sugarbaker DJ (1995) Neuronal control of esophageal function. Chest Surg Clin N Am 5:157–171PubMedGoogle Scholar
  12. 12.
    Tomita R, Kurosu Y, Munakata K (1997) Relationship between nitric oxide and non-adrenergic non-cholinergic inhibitory nerves in human lower esophageal sphincter. J Gastroenterol 32:1–5PubMedCrossRefGoogle Scholar
  13. 13.
    Blackshaw LA, Haupt JA, Omari T, Dent J (1997) Vagal and sympathetic influences on the ferret lower oesophageal sphincter. J Auton Nerv Syst 66:179–188PubMedCrossRefGoogle Scholar
  14. 14.
    Gilbert RJ, Dodds WJ (1987) Subtypes of muscarinic receptors in vagal inhibitory pathway to the lower esophageal sphincter of the opossum. Dig Dis Sci 32:1130–1135PubMedCrossRefGoogle Scholar
  15. 15.
    Sohn UD, Harnett KM, De Petris G, Behar J, Biancani P (1993) Distinct muscarinic receptors, G proteins and phospholipases in esophageal and lower esophageal sphincter circular muscle. J Pharmacol Exp Ther 267:1205–1214PubMedGoogle Scholar
  16. 16.
    Tottrup A, Forman A, Madsen G, Andersson KE (1990) The actions of some betareceptor agonists and xanthines on isolated muscle strips from human oesophago-gastric junction. Pharmacol Toxicol 67:340–343PubMedCrossRefGoogle Scholar
  17. 17.
    Thorpe JA (1980) Effect of propanolol on the lower oesophageal sphincter in man. Curr Med Res Opin 7:91–95PubMedCrossRefGoogle Scholar
  18. 18.
    Oriowo MA (1997) Beta3-adrenoceptors mediate smooth muscle relaxation in the rat lower esophageal sphincter. J Auton Pharmacol 17:175–182PubMedCrossRefGoogle Scholar
  19. 19.
    Blackshaw LA, Dent J (1997) Lower oesophageal sphincter responses to noxious oesophageal chemical stimuli in the ferret: involvement of tachykinin receptors. J Auton Nerv Syst 66:189–200PubMedCrossRefGoogle Scholar
  20. 20.
    Berquist WE, Rachelefsky GS, Kadden M, Siegel SC, Katz RM, Mickey MR, Ament ME (1981) Effect of theophylline on gastroesophageal reflux in normal adults. J Allergy Clin Immunol 67:407–411PubMedCrossRefGoogle Scholar
  21. 21.
    Vandenplas Y, De Wolf D, Sacre L (1986) The influence of xanthines on gastroesophageal reflux in infants at risk for sudden infant death syndrome. Pediatrics 77:807–810PubMedGoogle Scholar
  22. 22.
    Ekström T, Tibbling L (1988) Influence of theophylline on gastro-oesophageal reflux and asthma. Eur J Clin Pharmacol 35:353–356PubMedCrossRefGoogle Scholar
  23. 23.
    Hervé P, Escourrou P, Salmeron S, Gandolfo JY, Charley S, Denjean A, Petitpretz P, Simonneau G, Gaultier C, Duroux P (1993) Facteurs de risque de reflux gastrooesophagien dans l’asthme chronique. Rev Mal Respir 10:527–530PubMedGoogle Scholar
  24. 24.
    Johannesson N, Andersson KE, Joelsson B, Persson CG (1985) Relaxation of lower esophageal sphincter and stimulation of gastric secretion and diuresis by antiasthmatic xanthines. Role for adenosine antagonism. Am Rev Respir Dis 131:26–30Google Scholar
  25. 25.
    Hubert D, Gaudric M, Guerre J, Lockhart A, Marsac J (1988) Effect of theophylline on gastroesophageal reflux in patients with asthma. J Allergy Clin Immunol 81:1168–1174PubMedCrossRefGoogle Scholar
  26. 26.
    Berquist WE, Rachelesky GS, Rowshan N, Siegel S, Katz R, Welch M (1984) Quantitative gastroesophageal reflux and pulmonary function in asthmatic children and normal adults receiving placebo, theophylline, and metaproterenol sulfate therapy. J Allergy Clin Immunol 73:255–258CrossRefGoogle Scholar
  27. 27.
    Zfass AM, Prince R, Allen FN, Farrar JT (1970) Inhibitory beta-adrenergic receptors in the human distal esophagus. Dig Dis 15:303–310CrossRefGoogle Scholar
  28. 28.
    Di Marino AJ, Cohen S (1982) Effect of an oral beta-2 adrenergic agonist on lower esophageal sphincter pressure in normals and in patients with achalasia. Dig Dis Sci 27:1063–1066CrossRefGoogle Scholar
  29. 29.
    Wong RK, Maydonovitch C, Garcia JE, Johnson LF, Castell DO (1987) The effect of terbutaline sulfate, nitroglycerin, and aminophylline on lower esophageal sphincter pressure and radionuclide esophageal emptying in patients with achalasia. J Clin Gastroenterol 9:386–389PubMedCrossRefGoogle Scholar
  30. 30.
    Michoud MC, Ledue T, Proulx F, Perreault S, Du Souich P, Duranceau A, Amyot R (1991) Effect of salbutamol on gastroesophageal reflux in healthy volunteers and patients with asthma. J Allergy Clin Immunol 87:762–767PubMedCrossRefGoogle Scholar
  31. 31.
    Larsson S, Svedmyr N (1977) Bronchodilating effect and side effects of beta-2-adre-noceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). Am Rev Respir Dis 116:861–869PubMedGoogle Scholar
  32. 32.
    Schindlbeck NE, Heinrich C, Huber RM, Muller-Lissner SA (1988) Effects of albuterol (salbutamol) on esophageal motility and gastroesophageal reflux in healthy volunteers. JAMA 260:3156–3158PubMedCrossRefGoogle Scholar
  33. 33.
    Ruzkowski CJ, Sanowski RA, Austin J, Rohwedder JJ, Waring JP (1992) The effects of inhaled salbutamol and oral theophylline on gastroesophageal reflux in patients with gastroesophageal reflux disease and obstructive lung disease. Arch Intern Med 152:783–785PubMedCrossRefGoogle Scholar
  34. 34.
    Field SK, Underwood M, Brant R, Cowie RL (1996) Prevalence of gastroesophageal reflux symptoms in asthma. Chest 109:316–322PubMedCrossRefGoogle Scholar
  35. 35.
    McLean TR, Bombeck CT, Nyhus LM (1987) Distinction of lower esophageal sphincter strength from sphincter competence. Am J Surg 153:91–95PubMedCrossRefGoogle Scholar
  36. 36.
    Cotton BR, Smith G (1981) Comparison of the effects of atropine and glycopyrrolate on lower oesophageal sphincter pressure. Br J Anaesth 53:875–879PubMedCrossRefGoogle Scholar
  37. 37.
    Opie JC, Chaye H, Steward DJ (1987) Intravenous atropine rapidly reduces lower esophageal sphincter pressure in infants and children. Anesthesiology 67:989–990PubMedCrossRefGoogle Scholar
  38. 38.
    Martin CJ, Dodds WJ, Liem HH, Dantas RO, Layman RD, Dent J (1992) Diaphragmatic contribution to gastroesophageal competence and reflux in dogs. Am J Physiol 263:G551–G557PubMedGoogle Scholar
  39. 39.
    Aggestrup S, Jensen SL (1991) Effects of pirenzerpine and atropine on basal lower esophageal pressure and gastric acid secretion in man: a placebo-controlled randomized study. Dig Dis 9:360–364PubMedCrossRefGoogle Scholar
  40. 40.
    Gross NJ (1993) Safety and side-effects of anticholinergic bronchodilators. In: Gross NJ (ed) Anticholinergic therapy in obstructive airways disease. Franklin Scientific, London, 116–127Google Scholar
  41. 41.
    Mittal RK, Holloway R, Dent J (1995) Effect of atropine on the frequency of reflux and transient lower esophageal sphincter relaxation in normal subjects. Gastroenterology 109:1547–1554PubMedCrossRefGoogle Scholar
  42. 42.
    Mittal RK, Chiareli C, Liu J, Holloway R, Dixon W Jr (1997) Atropine inhibits gastric distension and pharyngeal receptor mediated lower oesophageal sphincter relaxation. Gut 41:285–290PubMedCrossRefGoogle Scholar
  43. 43.
    Lidums I, Checklin H, Mittal RK, Holloway RH (1998) Effect of atropine on gastro-oesophageal reflux and transient lower oesophageal sphincter relaxation in patients with gastro-oesophageal reflux disease. Gut 43:12–16PubMedCrossRefGoogle Scholar
  44. 44.
    Brown JH, Taylor P (1996) Muscarinic receptor agonists and antagonists. In: Hardman JG, Limbird LE, Milinoff PB, Euddon RW, Goodman Gilman A (eds) Goodman & Gilman’s the pharmacological basis of therapeutics, 9th edn. McGraw-Hill, New York, 141–160Google Scholar
  45. 45.
    Hamamoto J, Kohrogi H, Kawano O, Iwagoe H, Fujii K, Hirata N, Ando M (1997) Esophageal stimulation by hydrochloric acid causes neurogenic inflammation in the airways of guinea pigs. J Appl Physiol 82:738–745PubMedGoogle Scholar
  46. 46.
    Chung KF (1996) Effects of nedocromil sodium on airway neurogenic mechanisms. J Allergy Clin Immunol 98:S112–S116PubMedCrossRefGoogle Scholar
  47. 47.
    Nieber K, Baumgarten C, Rathsack R, Furkert J, Laake E, Muller S, Kunkel G (1993) Effect of azelastine on substance P content in bronchoalveolar and nasal lavage fluids of patients with allergic asthma. Clin Exp Allergy 23:69–71PubMedCrossRefGoogle Scholar
  48. 48.
    Paterson WG (1998) Role of most cell-derived mediators in acid-induced shortening of the esophagus. Am J Physiol 274:G385–G388PubMedGoogle Scholar
  49. 49.
    Blachshaw LA, Dent J (1988) Lower oesophageal sphincter responses to noxious oesophageal chemical stimuli in the ferret: involvment of tachykinin receptors. J Autonom Nerv Syst 13:189–200Google Scholar
  50. 50.
    Bechard D, Schubert M (1998) Gatroesophageal reflux-induced asthma: new insights. Gastroenterology 114:894–850CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 1999

Authors and Affiliations

  • M. Cazzola
    • 1
  • S. Centanni
    • 2
  • M. G. Matera
    • 1
  • R. W. Dal Negro
    • 3
  1. 1.Clinical Pharmacology Unit and Respiratory Pharmacology Centre, Salvatore Maugeri FoundationIRCCS, Rehabilitation InstituteVeruno (Novara)Italy
  2. 2.Institute of Respiratory DiseasesUniversity of MilanMilanItaly
  3. 3.Lung DepartmentBussolengo General HospitalBussolengo (Verona)Italy

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