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Asthma and gastroesophageal
reflux disease: Effect of long-term pantoprazole therapy
|
AIM:
To define the prevalence of gastroesophageal reflux disease (GERD) in mild
persistent asthma and to value the effect of pantoprazole therapy on
asthmatic symptoms.
METHODS:
Seven of thirty-four asthmatic patients without GERD served as the non-GERD
control group. Twenty-seven of thirty-four asthmatic patients had GERD (7/27
also had erosive esophagitis, sixteen of them presented GERD symptoms. An
upper gastrointestinal endoscopy was performed in all the subjects to obtain
five biopsy specimens from the lower 5 cm of the esophagus. Patients were
considered to have GERD when they had a dilation of intercellular space (DIS)
>0.74 mum at transmission electron microscopy. Patients with GERD were
treated with pantoprazole, 80 mg/day. Forced expiratory volume in one second
(FEV1) was performed at entry and after 6 mo of treatment. Asthmatic
symptoms were recorded. The required frequency of inhaling rapid acting
beta2-agonists was self-recorded in the patients' diaries.
RESULTS:
Seven symptomatic patients presented erosive esophagitis. Among the 18
asymptomatic patients, 11 presented DIS, while all symptomatic patients
showed ultrastructural esophageal damage. Seven asymptomatic patients did
not present DIS. At entry the mean of FEV(1) was 1.91 L in symptomatic GERD
patients and 1.88 L in asymptomatic GERD patients. After the treatment, 25
patients had a complete recovery of DIS and reflux symptoms. Twenty-three
patients presented a regression of asthmatic symptoms with normalization of
FEV(1). Four patients reported a significant improvement of symptoms and
their FEV(1) was over 80%.
CONCLUSION:
GERD is a highly prevalent condition in asthma patients. Treatment with
pantoprazole (80 mg/day) determines their improvement and complete
regression.
Reference:
World J Gastroenterol. 2005 Dec
28;11(48):7657-60. |
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