Abstract
The association between bronchial asthma and gastroesophageal reflux disease (GERD) has been reported repeatedly over the last 30 years [1–6], although the issue of cause and effect remains controversial. Reports about a certain kind of relationship between asthma and GERD date back to 1912 when Sir William Osier [7] stated that “asthma attacks may be due to direct irritation of the bronchial mucosa or … indirectly, too, by reflex influences from the stomach”. Dr. Osier’s insight about acid-induced bronchoconstriction remains true today. GERD, the retrograde movement of gastric contents into the esophagus, is a prevalent clinical condition affecting millions of adults around the world. An epidemiologic study performed in the USA in the 1970s suggested that 10% of the population has daily heartburn and more than one-third have intermittent symptoms [8]. More recently, another survey reported that 20% of 800 randomly selected adults had heartburn more than three times a month and another 25% noted heartburn at least once a month [9]. Untreated GERD impairs quality of life and can lead to esophageal complications such as esophagitis, ulceration, stricture and Barrett’s esophagus (replacement of squamous epithelium with columnar epithelium) with its tendency to become malignant [10]. However, the spectrum of problems associated with GERD has expanded to extraesophageal sites [11]. Chronic cough and asthma are two clinical problems caused or triggered by GERD [12, 13]. Furthermore, treatment of GERD may result in marked improvement or even disappearance of symptoms in patients with chronic cough or asthma [12,14]. One potentially critical consideration is that many asthmatic patients do not have classic reflux symptoms but only occasional asymptomatic regurgitation. This condition, although being able to elicit cough and asthma, leaves the clinician unaware that GERD may be playing a crucial role in their patients’ symptoms [15,16].
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References
Kennedy JH (1962) Silent gastroesophageal reflux: an important but little known cause of pulmonary complications. Dis Chest 42:42–45
Overholt RH, Voorhees RJ (1966) Esophageal reflux as a trigger in asthma. Dis Chest 49:464–466
Mays EE (1976) Intrinsic asthma in adults: association with gastroesophageal reflux. JAMA 236:2626–2628
Urschel HC, Paulson DL (1967) Gastroesophageal reflux and hiatal hernia: complications and therapy. J Thorac Cardiovasc Surg 53:21–32
Mansfield LE, Stein MR (1978) Gastroesophageal reflux and asthma: a possible reflex mechanism. Ann Allergy 41:224–726
Barish CF, Wu WC, Castell DO (1985) Respiratory complications of gastroesophageal reflux. Arch Intern Med 145:1882–1888
Osier WB (1912) The principles and practice of medicine, 8th edn. Appleton, New York, 628–631
Nebel OT, Fornes MF, Castell DO (1976) Symptomatic gastroesophageal reflux. Incidence and precipitating factors. Dig Dis Sci 21:953–956
A Gallup survey on heartburn across America (1988) The Gallup Organization, Princeton NJ
Richter JE, Castell DO (1982) Gastroesophageal reflux: pathogenesis, diagnosis and therapy. Ann Intern Med 97:93–103
Deschner WK, Benjamin SB (1989) Extraesophageal manifestations of gastroesophageal reflux disease. Am J Gastroenterol 84:1–5
Irwin RS, French CL, Curley FJ, et al (1993) Chronic cough due to gastroesophageal reflux: clinical, diagnostic, and pathogenetic aspects. Chest 104:1511–1517
Harding SM, Richter JE (1992) Gastroesophageal reflux disease and asthma. Semin Gastrointest Dis 3:139–150
Harding SM, Richter JE, Guzzo MR (1996) Asthma and gastroesophageal reflux: acid suppressive therapy improves asthma outcome. Am J Med 100:395–405
Irwin RS, Zawacki JK, Curley FJ, et al (1989) Chronic cough as the sole presenting manifestation of gastroesophageal reflux. Am Rev Respir Dis 140:1294–1300
Irwin RS, Curley FJ, French CL (1993) Difficult-to-control asthma: contributing factors and outcome of a systematic management protocol. Chest 103:1662–1669
Harding SM, Richter JE (1997) The role of gastroesophageal reflux in chronic cough and asthma. Chest 111:1389–1402
Mansfield LE, Hameister HH, Spaulding MS, et al (1981) The role of the vagus nerve in airway narrowing caused by intraesophageal hydrochloric acid provocation and esophageal distention. Ann Allergy 47:431–434
Wright RA, Miller SA, Corsello BF (1990) Acid-induced esophagobronchial cardiac reflexes in humans. Gastroenterology 99:71–73
Tan WC, Martin RJ, Pandy R, et al (1990) Effects of spontaneous and stimulated gastroesophageal reflux on sleeping asthmatics. Am Rev Respir Dis 141:1394–1399
Pomari GC, Micheletto C, Turco P, Dal Negro RW, et al (1995) Acid drink enhances methacholine responses in GER only in subjects showing hypoxic response to ultrasonically nebulized distilled water. Eur Respir J 10(25):66s
Herve P, Denjean A, Jian R, et al (1986) Intraesophageal perfusion of acid increases the bronchomotor response to methacholine and to isocapnic hyperventilation in asthmatic subjects. Am Rev Respir Dis 134:986–989
Chernow B, Johnson LF, Janowitz WR, et al (1979) Pulmonary aspiration as a consequence of gastroesophageal reflux: a diagnostic approach. Dig Dis Sci 24:839–844
Tuchman DN, Boyle JT, Pack AL, et al (1984) Comparison of airways responses following tracheal or esophageal acidification in the cat. Gastroenterology 87:872–881
Jack CIA, Calverley PMA, Donnelly RJ, et al (1995) Simultaneaous tracheal and esophageal pH measurements in asthmatic patients with gastroesophageal reflux. Thorax 50:201–204
Zfass AM, Prince R, Allen FN, Farrar JT (1970) Inhibitory beta-adrenergic receptors in the human distal esophagus. Am J Dig Dis 15:303–310
Di Marino AJ Jr, Cohen S (1982) Effect of an oral beta-2-adrenergic agonist on lower esophageal sphincter pressure in normals and in patients with achalasis. Dig Dis Sci 27:1063–1066
Boyle JT, Tuchman DN, Altschuler SM, et al (1985) Mechanisms for the association of gastroesophageal reflux and bronchospasm. Am Rev Respir Dis 131(Suppl):S16–S20
Moote DW, Lloyd DA, McCourtie DR, Wells GA (1986) Increase in gastroesophageal reflux during methacholine-induced bronchospasm. J Allergy Clin Immunol 78:619–623
Michoud MC, Leduc T, Proulx F, et al (1991) Effect of salbutamol on gastroesophageal reflux in healthy volunteers and patients with asthma. J Allergy Clin Immunol 87:762–767
Schindlbeck NE, Hinrich C, Huber RM, Muller-Lissner SA (1988) Effects of albuterol (salbutamol) on esophageal motility and gastroesophageal reflux in healthy volunteers. JAMA 260:3156–3158
Eastwood GL, Castell DD, Higgs RH (1975) Experimental esophagitis in cats impairs lower esophageal sphincter pressure. Gastroenterology 69:146–153
Andrew BL (1956) The nervous control of the cervical esophagus of the rat during swallowing. J Physiol (Lond) 134:729–740
Mansfield LE, Hameister HH, Spaulding HS, Smith NJ, Glab N (1981) The role of the vagus nerve in airway narrowing caused by intraesophageal hydrochloric acid provocation and esophageal distention. Ann Allergy 47:431–434
Abraham WM, Baugh LE (1995) Animal models of asthma. In: Busse WW, Holgate ST (eds) Asthma and rhinitis. Blackwell Scientific, Boston, 961–977
Soler M, Sielczak MW, Abraham WM (1989) A PAF-antagonist blocks antigen-induced airway hyperresponsiveness and inflammation in sheep. J Appl Physiol 67:406–413
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© 1999 Springer-Verlag Italia
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Scuri, M., Allegra, L., Negro, R.W.D., Pomari, C., Abraham, W.M. (1999). An Ovine Model of GERD-Induced Bronchoconstriction. In: Dal Negro, R.W., Allegra, L. (eds) Pneumological Aspects of Gastroesophageal Reflux. Springer, Milano. https://doi.org/10.1007/978-88-470-2147-1_5
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DOI: https://doi.org/10.1007/978-88-470-2147-1_5
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