Objective: To study the symptom correlation between gastroesophageal reflux (GER) and asthma, the significance of 24 hour esophageal pH monitoring in the diagnosis of GER and the efficacy of anti-reflux therapy in asthmatics with GER.
Methods: Twenty-six patients with asthma, who presented with refractory respiratory symptoms despite of regular anti-asthmatic treatment, were enrolled in the study. 24 hour ambulatory esophageal pH monitoring was performed and symptoms, such as cough, chest tightness and pyrosis were recorded. Peak expiratory flow (PEF) was performed hourly. GER was defined by DeMeester score > or = 14.72 or SAP (cough with reflux) > or = 95%. Patients with diagnosed GER were divided into two groups, one of which was given anti-reflux therapy.
Results: DeMeester score > or = 14.72 was found in 58% (15/26) of the patients. Symptom association probability (SAP) with cough > or = 95% was found in 2 patients with a DeMeester score < 14.72. Taken together, GER was diagnosed in 17 patients. After anti-reflux therapy, symptoms such as cough, chest tightness and pyrosis improved significantly, and the 24 hour PEF variability decreased significantly as compared to that before therapy [(38 +/- 8)% versus (16 +/- 3%, P < 0.05].
Conclusion: The incidence of GER was 58% in this group of moderate to severe asthmatic patients. 24 hour esophageal pH monitoring was of great value in diagnosing GER in asthmatic patients, and anti-reflux therapy was effective in improving symptoms induced by GER in those patients.