[Gastroesophageal reflux and asthma].

Gastro-oesophageal reflux (GOR) occurs with increased frequency in asthmatics. GOR may cause pulmonary symptoms either by reflux of gastric contents into the trachea or by a reflex mechanism. Several studies have shown that the presence of acid in the oesophagus may induce slight bronchospasm. However, more recent studies have clearly demonstrated that acidification of the oesophagus may exacerbate the bronchial hyperreactivity characteristic of the asthmatic patient, thus rendering the patient more susceptible to bronchoconstriction by other stimuli. As some drugs used in the treatment of asthma decrease lower oesophageal sphincter pressure and thereby enhance GOR, a vicious circle may arise. As surgical and medical anti-reflux therapy has been shown to be effective in diminishing asthmatic symptoms in the asthmatic patient with proven GOR, 24-hour ambulatory oesophageal pH monitoring is recommended in order to detect such patients and give them a trial with an H2 receptor antagonist.