MedWire News: Bronchial hyperreactivity (BHR) is common among non-atopic children with asthma who also suffer from gastroesophageal reflux disease (GERD), study results show.
“Studies have shown increased airway hyperresponsiveness with acid exposure of the esophagus… in adult patients with asthma and GERD,” explain Vikram Khoshoo (West Jefferson Medical Center, New Orleans, Louisiana, USA) and colleagues.
But they add that “similar data on BHR in children with GERD and asthma are lacking.”
To address this, the team assessed data on 30 non-atopic children, aged 6–13 years, with moderate, persistent asthma and reflux symptoms who participated in a long-term respiratory health study.
Extended esophageal pH monitoring was used to diagnose GERD, and responses to methacholine challenge tests (MCT) performed before and 2 years after the start of anti-GERD treatment were used to identify BHR.
In total, 21 participants were diagnosed with GERD, 15 of whom (group A) had a positive MCT result before receiving anti-GERD treatment, indicating the presence of BHR. Of the nine children without GERD, five (group B) had a positive MCT results.
Two years after the start of anti-GERD therapy, 11 children in group A tested negative for BHR, compared with three in group B.
The researchers note in the journal Pediatric Pulmonology that children in group A experienced fewer asthma exacerbations and used less asthma medication after receiving anti-GERD treatment than children in group B.
Khoshoo and team conclude: “The results of our study suggest that a majority of children with asthma with GERD have evidence of BHR.
“This BHR decreases after prolonged anti-GERD treatment… despite reduction in the concomitant asthma medications.”
They add that further research should examine BHR in atopic children with asthma and GERD, as “the natural history of BHR in these patients may follow different paths.”
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