Bronchial Asthma and GER

  • L. Allegra


In 1935, Winkelstein proposed a new pathological entity called peptic esophagitis [1]. Several years later the term reflux esophagitis was introduced to indicate the pathophysiological mechanism underlying the disease [2]. It was later demonstrated that gastroesophageal reflux (GER) may occur even in the absence of esophagitis, and the more comprehensive term gastroesophageal reflux disease (GERD) was introduced, to include disturbances and disease processes due to GERD that involve other organs besides the esophagus. Specific attention has been drawn to diseases of the respiratory tract: association with asthma (although hypothesized by Sir W. Osler a long time ago [3] and sporadically mentioned thereafter [4, 5] and chronic bronchitis was described in the late 1970s [6–8] with a progressively increasing interest [9–19], whereas an association between reflux and idiopathic pulmonary fibrosis (IPF) was suggested in the 1960s [20] and confirmed successively [21–25]. Other respiratory disturbances such as persistent chronic cough [26–29] and nocturnal asphyxia in children [30] were reported later than asthma and IPF. Further associations, although not supported scientifically have been suspected (e.s. bronchiectasis, hemoptysis). Proof has been given regarding the relationship between GER and hoarseness [31] or far more severe upper airway diseases [32, 33] such as acute or chronic laryngitis [34–38], laryngeal ulcers [39] and even glottic carcinoma [40, 41].


Gastroesophageal Reflux Idiopathic Pulmonary Fibrosis Lower Esophageal Sphincter Reflux Episode Glottic Carcinoma 


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  1. 1.
    Winkelstein A (1935) Peptic esophagitis: a new clinical entity. JAMA 104:906–909CrossRefGoogle Scholar
  2. 2.
    Allison PR (1946) Peptic ulcer of the esophagus. J Thorac Surg 15:308–317PubMedGoogle Scholar
  3. 3.
    Osier WB (1912) The principles and practice of medicine, 8th edn. D. Appleton, New York, 628–631Google Scholar
  4. 4.
    Clemencon GH, Osterman PO (1961) Hiatal hernia in bronchial asthma: the importance of concomitant pulmonary emphysema. Gastroenterology 95:110–120CrossRefGoogle Scholar
  5. 5.
    Overholt RH, Ashraf MM (1966) Esophageal reflux as a trigger of asthma. NY State J Med 66:3030–3032Google Scholar
  6. 6.
    Danus O, Casar L, Latrain A, Pope CE II (1976) Esophageal reflux and unrecognized cause of recurrent obstructive bronchitis in children. J Pediatr 89:220–224PubMedCrossRefGoogle Scholar
  7. 7.
    Christie DL, O’Grady LR, Mack DV (1978) Incompetent lower esophageal reflux in recurrent acute pulmonary disease of infancy and childhood. J Pediatr 93:23–27PubMedCrossRefGoogle Scholar
  8. 8.
    Mansfield LE, Stein MR (1978) Gastroesophageal reflux and asthma: a possible reflex mechanism. Ann Allergy 41:224–226PubMedGoogle Scholar
  9. 9.
    Tuchman DN, Boyle JT, Pack AI, Schwartz J, Kokonos M, Spitzer AR, Cohen S (1984) Comparison of airway response following tracheal esophageal acidification in the cat. Gastroenterology 87:872–881PubMedGoogle Scholar
  10. 10.
    Hoyoux C, Forget T, Lambrich L, Geubelle F (1985) Chronic bronchopulmonary disease and gastroesophageal reflux in children. Pediatr Pulmonol 1:149–153PubMedCrossRefGoogle Scholar
  11. 11.
    Gustafsson PM, Kjellman NI, Tibbling L (1986) Oesophageal function and symptoms in moderate and severe asthma. Acta Pediatr Scand 5:729–733CrossRefGoogle Scholar
  12. 12.
    Ducoloné A, Vandevenne A, Jouin H, Grob JC, Coumaros D, Meyer C, Burghard G, Methlin G, Hollender L (1987) Gastroesophageal reflux in patients with asthma and chronic bronchitis. Am Rev Respir Dis 135:327–332PubMedGoogle Scholar
  13. 13.
    Crausaz FM, Favez G (1988) Aspiration of solid food particles into the lungs of patients with gastroesophageal reflux and chronic bronchial disease. Chest 93:376–378PubMedCrossRefGoogle Scholar
  14. 14.
    Perrin-Fayolle M (1990) Gastroesophageal reflux and chronic respiratory disease in adults: influence and results of surgical therapy. Clin Rev Allergy 8:457–469PubMedGoogle Scholar
  15. 15.
    Sontag SJ, O’Connel 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
  16. 16.
    Larrain A, Carrasco E, Galleguillos F, Sepulveda R, Pope CE II (1991) Medical and surgical treatment of nonallergic asthma associated with gastroesophageal reflux. Chest 99:1330–1335PubMedCrossRefGoogle Scholar
  17. 17.
    Donnelly RJ, Berrisford RG, Jack CI, Tran JA, Evans CC (1993) Simultaneous tracheal and esophageal pH monitoring: investigating reflux associated asthma. Ann Thorac Surg 56:1029–1033PubMedCrossRefGoogle Scholar
  18. 18.
    Simpson WG (1995) Gastroesophageal reflux and asthma: diagnosis and management. Arch Intern Med 155:798–803PubMedCrossRefGoogle Scholar
  19. 19.
    Harding SM, Richter JE, Guzzo MR, Schan G, Alexander RW, Bradley LA (1996) Asthma and gastroesophageal reflux: acid suppressive therapy improves asthma outcome. Am J Med 100:395–405PubMedCrossRefGoogle Scholar
  20. 20.
    Moran TJ (1965) Experimental aspiration pneumonia: IV. Inflammatory and reparative changes produced by intratracheal injections of autologous gastric juice and hydrochloric acid. Arch Pathol 60:122–129Google Scholar
  21. 21.
    Pearson JEG, Wilson RSE (1971) Diffuse pulmonary fibrosis and hiatus hernia. Thorax 26:300–305PubMedCrossRefGoogle Scholar
  22. 22.
    Sladen A, Zanca P, Hadnott WH (1971) Aspiration pneumonitis: the sequelae. Chest 59:448–450PubMedCrossRefGoogle Scholar
  23. 23.
    Downs JB, Chapman RL, Modell JH, Hood CI (1974) An evaluation of steroid therapy in aspiration pneumonitis. Anesthesiology 40:129–135PubMedCrossRefGoogle Scholar
  24. 24.
    Mays EE, Dubois JJ, Hamilton GB (1976) Pulmonary fibrosis associated with tracheobronchial aspiration: a study of the frequency of hiatal hernia and gastroesophageal reflux in interstitial pulmonary fibrosis of obscure etiology. Chest 69:512–515PubMedCrossRefGoogle Scholar
  25. 25.
    Tobin RW, Pope CE II, Pellegrini CA, Emond MJ, Sillery J, Raghu G (1998) Increased prevalence of gastroesophageal reflux in patients with idiopathic pulmonary fibrosis. Am J Respir Care Med 158:1804–1808Google Scholar
  26. 26.
    Irwin RS, Corrao WM, Pratter MR (1981) Chronic persistent cough in the adult: the spectrum and frequency of causes and successful outcome of specific therapy. Am Rev Respir Dis 123:413–417PubMedGoogle Scholar
  27. 27.
    Irwin RS, Zawacki JK, Curley FJ, French CL, Hoffman P (1989) Chronic cough as the sole presenting manifestation of gastroesophageal reflux. Am Rev Respir Dis 140:1294–1300PubMedCrossRefGoogle Scholar
  28. 28.
    Irwin RS, Curley FJ, French CL (1990) Chronic cough: the spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of the specific therapy. Am Rev Respir Dis 141:640–647PubMedCrossRefGoogle Scholar
  29. 29.
    Ing AJ, Ngu MC, Breslin ABX (1994) The pathogenesis of chronic persistent cough associated with gastroesophageal reflux. Am J Respir Crit Care Med 149:160–167PubMedGoogle Scholar
  30. 30.
    Herbst JJ, Book LS, Bry PF (1978) Gastroesophageal reflux in the “near miss” sudden infant death syndrome. J Pediatr 92:73–75PubMedCrossRefGoogle Scholar
  31. 31.
    Weiner GJ, Koufman JA, Wu WC, Cooper JB, Richter JE, Castell DO (1989) Chronic hoarseness secondary to gastroesophageal reflux disease: documentation with 24-h ambulatory pH monitoring. Am J Gastroenterol 84:1503–1508Google Scholar
  32. 32.
    Koufman JA (1991) The otolaryngologic manifestation of gastroesophageal disease. Laryngoscope 10[Suppl 53]:1–78Google Scholar
  33. 33.
    Cote DN, Miller RH (1995) The association of gastroesophageal reflux and otolaryngologic disorders. Compr Ther 21:80–84PubMedGoogle Scholar
  34. 34.
    Kambic V, Radsel Z (1984) Acid posterior laryngitis aetiology, histology diagnosis and treatment. J Laryngol Otol 98:1237–1240PubMedCrossRefGoogle Scholar
  35. 35.
    Gaynor EB (1988) Gastroesophageal reflux as aetiologic factor in laryngeal complications of intubation. Laryngoscope 98:972–979PubMedCrossRefGoogle Scholar
  36. 36.
    Jacob P, Kahrilas PJ, Herzon G (1991) Proximal esophageal pH-metry in patients with “reflux laryngitis”. Gastroenterology 100:305–310PubMedGoogle Scholar
  37. 37.
    Kamel PL, Hanson D, Kahrilas PJ (1994) Prospective trial of omeoprazole in the treatment of posterior laryngitis. Am J Med 96:321–326PubMedCrossRefGoogle Scholar
  38. 38.
    Hanson DG, Kamel PL, Kahrilas PJ (1995) Outcomes of anti-reflux therapy in the treatment of chronic laryngitis. Ann Otol Rhinol Laryngol 104:550–555PubMedGoogle Scholar
  39. 39.
    Cherry J, Margulies SI (1968) Contact ulcer of the larynx. Laryngoscope 78:1937–1940PubMedCrossRefGoogle Scholar
  40. 40.
    Morrison MD (1988) Is chronic gastroesophageal reflux a causative factor in glottic carcinoma? Otolaryngol Head Neck Surg 99:370–373PubMedGoogle Scholar
  41. 41.
    Ward PH, Hanson DG (1988) Reflux as etiologic factor of carcinoma of the laryngopharynx. Laryngoscope 98:1195–1199PubMedGoogle Scholar
  42. 42.
    Savary M, Miller G (1977) Handbuch und Endoskopisches Atlas. Grassman Verlag, Solothurn (Schweitz)Google Scholar
  43. 43.
    Berquist VE, Rachelefski GS, Kadden M, Siegel SC, Katz RM, Fonkalsrud ES, Ament ME (1981) Gastroesophageal reflux associated with recurrent pneumonia and asthma in children. Pediatrics 68:29–35PubMedGoogle Scholar
  44. 44.
    Allen CJ, Craven MA, Waterfall WE, Newhouse MT (1989) Gastroesophageal reflux and chronic respiratory disease. In: Baum G, Wolinsky E (eds) Textbook of pulmonary diseases, 4th edn. Little, Brown, Boston, 1471–1486Google Scholar
  45. 45.
    Chernow B, Castell DO (1977) Asthma and gastroesophageal reflux. JAMA 37:2379 (letter)CrossRefGoogle Scholar
  46. 46.
    Sontag SJ, Schnell TG, Miller TQ, Khandelwal S, O’Connel S, Chejfee G, Greenlee H, Seidel UJ, Brand L (1992) Prevalence of oesophagitis in asthmatics. Gut 33:872–876PubMedCrossRefGoogle Scholar
  47. 47.
    Bannister WK, Sattilaro AJ, Otis RD (1961) Therapeutic aspects of aspiration pneumonitis in experimental animals. Anesthesiology 22:440–443PubMedCrossRefGoogle Scholar
  48. 48.
    Karlsson JA, Sant’Ambrogio G, Widdicombe J (1988) Afferent neural pathways in cough and reflex bronchoconstriction. J Appl Physiol 65:1007–1023PubMedGoogle Scholar
  49. 49.
    Cunningham ET Jr, Ravich WJ, Jones B, Donner MW (1992) Vagal reflexes referred from the upper aerodigestive tract: an infrequently recognized cause of cardiorespiratory response. Ann Intern Med 116:575–582PubMedGoogle Scholar
  50. 50.
    Ghaed N, Stein M (1979) Assessment of a technique for scintigraphic monitoring of pulmonary aspiration of gastric contents in asthmatics with gastroesophageal reflux. Ann Allergy 42:306–308PubMedGoogle Scholar
  51. 51.
    Greyson ND, Reid RH, Lin YC, Thomas P (1982) Radionuclide assessment in nocturnal asthma. Clin Nucl Med 7:318–319PubMedCrossRefGoogle Scholar
  52. 52.
    Ruth M, Carlsson S, Mansson I, Bengtsson U, Sandberg N (1993) Scintigraphic detection of gastropulmonary aspiration in patients with respiratory disorders. Clin Physiol 13:19–33PubMedCrossRefGoogle Scholar
  53. 53.
    Schan CA, Harding SM, Haile JM, Bradley LA, Richter JE (1994) Gastroesophageal reflux-induced bronchoconstriction: an intraesophageal acid infusion study using state-of-the art technology. Chest 106:731–737PubMedCrossRefGoogle Scholar
  54. 54.
    Harding SM, Schan CA, Guzzo MR, Alexander RW, Bradley LA, Richter JE (1995) Gastroesophageal reflux-induced bronchoconstriction: is microaspiration a factor? Chest 108:1220–1227PubMedCrossRefGoogle Scholar
  55. 55.
    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 provocative and esophageal distention. Ann Allergy 47:431–434PubMedGoogle Scholar
  56. 56.
    Spaulding HS Jr, Mansfield LE, Stein MR, Sellner JC, Gremillion DE (1982) Further investigation of the association between gastroesophageal reflux and bronchoconstriction. J Allergy Clin Immunol 69:516–521PubMedCrossRefGoogle Scholar
  57. 57.
    Andersen LI, Schmidt A, Bundgaard A (1986) Pulmonary function and acid application in the esophagus. Chest 90:358–363PubMedCrossRefGoogle Scholar
  58. 58.
    Harding SM, Guzzo MR, Maples R, Alexander RW, Richter E (1995) Gastroesophageal reflux induced bronchoconstriction: vagolytic doses of atropine diminish airway responses to esophageal acid infusion. Am J Respir Crit Care Med 151: A589 (abstract)Google Scholar
  59. 59.
    Hervé P, Denjean A, Jian R, Simonneau G, Duroux P (1986) Intraesophageal perfusion of acid increases the bronchomotor response to methacholine and to isocapnic hyperventilation in asthmatic subjects. Am Rev Respir Dis 134:986–989PubMedGoogle Scholar
  60. 60.
    Ekström T, Tibbling L (1989) Esophageal acid perfusion, airway function and symptoms in asthmatic patients with marked bronchial hyperreactivity. Chest 96:995–998PubMedCrossRefGoogle Scholar
  61. 61.
    Allegra L, Tognella S (1997) Malattia da reflusso gastroesofageo ed asma. In: Allegra L (ed) Valutazione e gestione del paziente asmatico. Editeam, Castello d’Argile (Bologna), 23–27Google Scholar
  62. 62.
    Perrin-Fayolle M, Bel A, Kofman J, Harf R, Montagon B, Pacheco Y, Dandet J, Nessoz J, Perpoint B (1980) Asthma and gastroesophageal reflux. Results of the survey of over 150 cases. Poumon Coeur 36:225–230PubMedGoogle Scholar
  63. 63.
    Scuri M, Allegra L, Dal Negro RW, Pomari C, Abraham WM (1999) An ovine model of GERD-induced bronchoconstriction. In: Dal Negro RW, Allegra L (eds) Pneumological aspects of gastroesophageal reflux. Springer, Milan, 43–52CrossRefGoogle Scholar
  64. 64.
    Visconti A, Cuttitta G, Insalaco G, Peralta G, Catania G, Trizzino A, Bonsignore G (1990) Gastroesophageal reflux and nocturnal bronchoconstriction. In: Olivieri D, Bianco S (eds) Airway Obtruction and Inflammation. Progress Respir Res, vol. 24, Karger, Basel, 179–182Google Scholar
  65. 65.
    Depla AC (1989) Gastroesophageal reflux in patients with bronchial asthma. Digestion 44[Suppl l]:63–67PubMedCrossRefGoogle Scholar
  66. 66.
    Ekström T, Tibbling L (1989) Can mild bronchospasm reduce gastroesophageal reflux? Am Rev Respir Dis 139:52–55PubMedCrossRefGoogle Scholar
  67. 67.
    Bartlett SG, Gorbach SL, Finegolo SM (1974) The bacteriology of aspiration pneumonia. Am J Med 56: 202–207PubMedCrossRefGoogle Scholar
  68. 68.
    Lorber B, Swenson RM (1974) Bacteriology of aspiration pneumonia. A prospective study of community-and hospital-acquired cases. Ann Inter Med 81:329–331Google Scholar
  69. 69.
    Downing SE, Lee JC (1975) Laryngeal chemosensitivity: a possible mechanism for sudden infant death. Pediatrics 55:640–649PubMedGoogle Scholar
  70. 70.
    Harned HS, Myracle J, Ferriero J (1978) Respiratory suppression and swallowing from introduction of fluids into the laryngeal region of the lamb. Pediatr Res 12:1003–1009PubMedCrossRefGoogle Scholar
  71. 71.
    Irwin RS, Curley FJ, French CL (1981) Chronic persistent cough in the adult: the spectrum and frequency of causes and successful outcome of specific therapy. Am Rev Respir Dis 123:413–417PubMedGoogle Scholar
  72. 72.
    Andze GO, Brandt ML, St Vil D, Bensoussan AL, Blanchard H (1991) Diagnosis and treatment of gastroesophageal reflux in 500 children with respiratory symptoms: the value of pH monitoring. J Pediatr Surg 26:295–300PubMedCrossRefGoogle Scholar
  73. 73.
    Allegra L (1998) Asma e GERD. Aria Ambiente Salute l(4):31–32Google Scholar
  74. 74.
    Allegra L (1999) Malattie respiratoriee reflusso gastroesofageo. Giorn It Mal Tor 53:15–22Google Scholar
  75. 75.
    Sondheimer JM (1998) Gasteroesophageal reflux: update on pathogenesis and diagnosis. Pediatr Clin North Am 35:103–116Google Scholar
  76. 76.
    Orenstein SR (1993) Gastroesophageal reflux. In: Wyllie R, Hyams JS (eds) Pediatric gastrointestinal disease: pathophysiology, diagnosis, management. WB Saunders, Philadelphia, 337–369Google Scholar
  77. 77.
    Welch RW, Luckmann K, Ricks P (1980) Lower esophageal sphincter pressure in histologic esophagitis. Dig Dis Sci 25:420–426PubMedCrossRefGoogle Scholar
  78. 78.
    De Meester TR, Johnson LF, Joseph GJ, Toscano MS, Hall AW, Skinner DB (1976) Patterns of gastroesophageal reflux in health and disease. Ann Surg 184:459–470CrossRefGoogle Scholar
  79. 79.
    Jack CIA, Walshaw MJ, Tran J, Hind CRK, Evans CC (1994) Twenty-four-hour tracheal pH monitoring — a simple and non-hazardous investigation. Respir Med 88:441–444PubMedCrossRefGoogle Scholar
  80. 80.
    Jack CIA, Calverley PMA, Donnelly RJ, Tran J, Russel G, Hind CRK, Evans CC (1995) Simultaneous tracheal and esophageal pH measurements in asthmatic patients with gastro-esophageal reflux. Thorax 50:201–204PubMedCrossRefGoogle Scholar
  81. 81.
    Gonzalez-Fernandez F, Arguelles-Martin F, Rodriguez de Quesada B (1987) Gastroesophageal scintigraphy: an useful screening test for GE reflux. J Pediatr Gastroenterol Nutr 6:217–219PubMedCrossRefGoogle Scholar
  82. 82.
    Barish CF, Wu WC et al (1985) Respiratory complication of gastroesophageal reflux. Arch Intern Med 145:1882–1988PubMedCrossRefGoogle Scholar
  83. 83.
    Tolia V, Kuhns L (1993) Comparison of simultaneous esophageal pH monitoring and scintigraphy in infants with gastroesophageal reflux. Am J Gastroenterol 88:661–664PubMedGoogle Scholar
  84. 84.
    Bernstein LM, Baker LA (1958) A clinical test for esophagitis. Gastroenterology 34:760–781PubMedGoogle Scholar
  85. 85.
    Perpina M, Ponce J, Marco V, Benlloch E, Miralbes M, Berenguer J (1983) The prevalence of asymptomatic gastroesophageal reflux in bronchial asthma and in non-asthmatic individuals. Eur J Respir Dis 64:582–587PubMedGoogle Scholar
  86. 86.
    Perpina M, Pellicer C, Marco V, Maldonado J, Ponce J (1985) The significance of the reflex bronchoconstriction provoked by gastroesophageal reflux in bronchial asthma. Eur J Respir Dis 66:91–97PubMedGoogle Scholar
  87. 87.
    Caletti GC, Ferrari A, Mattoli S, Zannoli R, Di Simone MB, Bocus P, Gozetti G, Barbara L (1997) Endoscopy vs ultrasonography in staging reflux esophagitis. Endoscopy 26:794–797CrossRefGoogle Scholar
  88. 88.
    Westra SJ, Wolf BHM, Stealman CR (1990) Ultrasound diagnosis of gastroesophageal reflux and hiatus hernia in young children. J Clin Ultrasound 18:477–485PubMedCrossRefGoogle Scholar
  89. 89.
    Westra SJ, Derkx HHF, Taminiau JA (1994) Symptomatic gastroesophageal reflux: diagnosis with ultrasound. J Pediatr Gastroenterol Nutr 19:58–64PubMedCrossRefGoogle Scholar
  90. 90.
    Vigneri S, Termini R, Leandro G, Badalamenti S, Pantalena M, Savarino V, Di Mario F, Battaglia G, Mela GS, Pilotto A, Plebani M, Davi G (1995) A comparison of five maintenance therapies for reflux esophagitis. N Engl J Med 333:1106–1110PubMedCrossRefGoogle Scholar
  91. 91.
    Field SK, Sutherland LR (1998) Does medical antireflux therapy improve asthma in asthmatics with gastroesophageal reflux? A critical review of the literature. Chest 114:275–283PubMedCrossRefGoogle Scholar
  92. 92.
    Kjellen G, Tibbling L, Wranne B (1981) Effect of conservative treatment of esophageal dysfunction on bronchial asthma. Eur J Respir Dis 62:190–197PubMedGoogle Scholar
  93. 93.
    Goodhall RJ, Earis JE, Cooper DN, Bernstein A (1981) Relationship between asthma and gastro-oesophageal reflux. Thorax 36:116–121CrossRefGoogle Scholar
  94. 94.
    Harper PC, Bergren A, Kaye MD (1987) Anti-reflux treatment in asthma: improvement in patients with associated gastroesophageal reflux. Arch Intern Med, 147: 56–60PubMedCrossRefGoogle Scholar
  95. 95.
    Ekström T, Lindgren BR, Tibbling L (1989) Effects of ranitidine treatment on patient with asthma and a history of gastro-oesophageal reflux: a double blind cross over study. Thorax 44:19–23PubMedCrossRefGoogle Scholar
  96. 96.
    Gustafsson PM, Kjellman WIM, Tibbling L (1992) A trial of ranitidine in asthmatic children and adolescents with or without pathological gastroesophageal reflux. Eur Respir J 5:201–206PubMedGoogle Scholar
  97. 97.
    Tucci J, Resti M, Fontana R, Novembre E, Lami CA, Vierucci A (1993) Gastroesophageal reflux and bronchial asthma: prevalence and effect of cisapride therapy. J Pediatr Gastroenterol Nutr 17:265–270PubMedCrossRefGoogle Scholar
  98. 98.
    Maton PN (1991) Omeprazole. N Engl J Med 324:965–975PubMedCrossRefGoogle Scholar
  99. 99.
    Dal Negro RW, Pomari C, Turco P, Allegra L (1994) Gastroesophageal reflux and bronchial asthma: a cross-over omeprazole vs placebo comparison. Am J Respir Crit Care 149:A202 (abstract)Google Scholar
  100. 100.
    Meier JH, McNally PR, Punja M, Freeman SR, Sudduth RH, Stocker N, Perry M, Spaulding HS (1994) Does omeprazole improve respiratory function in asthmatics with gastroesophageal reflux? A double-blind, placebo-controlled crossover study. Dig Dis Sci 39:2127–2133PubMedCrossRefGoogle Scholar
  101. 101.
    Ford GA, Oliver PS, Prior JS, Butland RJ, Wilkinson SP (1994) Omeprazole in the treatment of asthmatics with nocturnal symptoms and gastro-oesophageal reflux: a placebo-controlled cross-over study. Postgrad Med J 70:350–354PubMedCrossRefGoogle Scholar
  102. 102.
    Teichtal H, Kronborg IJ, Yeomans ND, Robinson P (1996) Adult asthma and gastrooesophageal reflux: the effects of omeprazole therapy on asthma. Aust NZ J Med 26:671–676CrossRefGoogle Scholar
  103. 103.
    Dal Negro R, Pomari C, Micheletto C, Turco P (1996) Omeprazole, but not placebo, reduces the bronchial response to methacholine in mild nonatopic asthmatics with gastroesophageal reflux. Am J Respir Crit Care Med 153:A517 (abstract)Google Scholar

Copyright information

© Springer-Verlag Italia 1999

Authors and Affiliations

  • L. Allegra
    • 1
  1. 1.Institute of Respiratory Diseases, University of MilanMilanItaly

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