Gastroesophageal reflux disease and childhood asthma

被引:36
作者
Blake, Kathryn [1 ]
Teague, William G. [2 ]
机构
[1] Nemours Childrens Clin Jacksonville, Biomed Res Dept, Ctr Pharmacogen & Translat Res, Jacksonville, FL USA
[2] Univ Virginia, Sch Med, Dept Pediat, Div Pediat Resp Med & Allergy, Charlottesville, VA 22908 USA
基金
美国国家卫生研究院;
关键词
asthma; gastroesophageal reflux disease; lansoprazole; pH monitoring studies; proton-pump inhibitors; PROTON PUMP INHIBITORS; ESOPHAGEAL SPHINCTER FUNCTION; RESPIRATORY SYMPTOMS; CHILDREN; AIRWAY; RISK; VALIDATION; THERAPY;
D O I
10.1097/MCP.0b013e32835b582b
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Purpose of review Gastroesophageal reflux disease (GERD) is common in children with asthma and may be present with or without symptoms. Clinicians, influenced by position statements in national guidelines, have routinely treated children with poorly controlled asthma with various anti-GERD medications. This practice is based on the pervasive but unproven belief that GERD is an important determinant of poor asthma control. Recent findings Clinical studies show that GERD is highly prevalent in children with asthma, with estimates as high as 80%, but nearly half of the children are asymptomatic. However, there is no conclusive evidence per se that asymptomatic GERD informs asthma control, and treatment of GERD in the few controlled trials available for review does not substantively improve asthma outcomes. In a recent large controlled clinical trial, treatment with a proton-pump inhibitor (PPI) was not only ineffective, but adverse effects were common, including an increased prevalence of symptomatic respiratory infections. Summary Current evidence does not support the routine use of anti-GERD medications in the treatment of poorly controlled asthma of childhood. However large controlled trials of children symptomatic of both GERD and asthma have not been conducted, and in this case the benefits of treatment, although unproven, might outweigh the risks.
引用
收藏
页码:24 / 29
页数:6
相关论文
共 43 条
[1]   DIAGNOSIS AND TREATMENT OF GASTROESOPHAGEAL REFLUX IN 500 CHILDREN WITH RESPIRATORY SYMPTOMS - THE VALUE OF PH MONITORING [J].
ANDZE, GO ;
BRANDT, ML ;
STVIL, D ;
BENSOUSSAN, AL ;
BLANCHARD, H .
JOURNAL OF PEDIATRIC SURGERY, 1991, 26 (03) :295-300
[2]  
Barberio G, 1989, Minerva Pediatr, V41, P363
[3]  
Bediwy AS, 2011, INT J PEDIAT, V2011, DOI [10.1155/2011967460, 10.1155/2011/967460]
[4]   MATURATION OF LOWER ESOPHAGUS [J].
BOIXOCHOA, J ;
CANALS, J .
JOURNAL OF PEDIATRIC SURGERY, 1976, 11 (05) :749-756
[5]   Therapy with gastric acidity inhibitors increases the risk of acute gastroenteritis and community-acquired pneumonia in children [J].
Canani, RB ;
Cirillo, P ;
Roggero, P ;
Romano, C ;
Malamisura, B ;
Terrin, G ;
Passariello, A ;
Manguso, F ;
Morelli, L ;
Guarino, A .
PEDIATRICS, 2006, 117 (05) :E817-E820
[6]   Proton Pump Inhibitor Use in Infants: FDA Reviewer Experience [J].
Chen, Ii-Lun ;
Gao, Wen-Yi ;
Johnson, Aisha P. ;
Niak, Ali ;
Troiani, John ;
Korvick, Joyce ;
Snow, Nancy ;
Estes, Kristina ;
Taylor, Amy ;
Griebel, Donna .
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 2012, 54 (01) :8-14
[7]   The pattern of gastroesophageal reflux in asthmatic children [J].
Cinquetti, M ;
Micelli, S ;
Voltolina, C ;
Zoppi, G .
JOURNAL OF ASTHMA, 2002, 39 (02) :135-142
[8]   Spontaneous gastroesophageal reflux and airway patency during the night in adult asthmatics [J].
Cuttitta, G ;
Cibella, F ;
Visconti, A ;
Scichilone, N ;
Bellia, V ;
Bonsignore, G .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2000, 161 (01) :177-181
[9]   Epidemiology of gastrooesophageal reflux disease: A systematic review [J].
Dent, J ;
El-Serag, HB ;
Wallander, MA ;
Johansson, S .
GUT, 2005, 54 (05) :710-717
[10]   Effects of Asymptomatic Proximal and Distal Gastroesophageal Reflux on Asthma Severity [J].
DiMango, Emily ;
Holbrook, Janet T. ;
Simpson, Erin ;
Reibman, Joan ;
Richter, Joel ;
Narula, Surinder ;
Prusakowski, Nancy ;
Mastronarde, John G. ;
Wise, Robert A. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2009, 180 (09) :809-816