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Am. J. Respir. Crit. Care Med., Volume 161, Number 1, January 2000, 177-181

Spontaneous Gastroesophageal Reflux and Airway Patency during the Night in Adult Asthmatics

GIUSEPPINA CUTTITTA, FABIO CIBELLA, ALFREDO VISCONTI, NICOLA SCICHILONE, VINCENZO BELLIA, and GIOVANNI BONSIGNORE

Istituto di Fisiopatologia Respiratoria del Consiglio Nazionale delle Ricerche, and Istituto di Pneumologia dell'Università, Palermo, Italy

Controversies still exist on the role of nighttime gastroesophageal reflux (GER) in precipitating nocturnal asthma. We tested the relationship between GER and nocturnal bronchoconstriction by continuously and simultaneously monitoring both respiratory resistances and esophageal pH in seven asthmatics with moderate to severe GER disease. Twenty-nine GER episodes were found during the study night lasting more than 5 min (LGER) and 72 not longer than 5 min (SGER). Both long (LGER) and short (SGER) gastroesophageal refluxes were able to maintain significantly higher lower respiratory resistances (RLR) at the resolution of each GER episode (RLRe) with respect to baseline values. RLR, expressed as the area under the RLR curve along each GER episode (AUCRLR) and as RLRe, showed significant correlations with GER duration. Moreover, a significant correlation was found between RLR measured 10 min after GER resolution and GER duration during each episode. We conclude that GER itself is able to elicit nocturnal bronchoconstriction in asthmatics with moderate to severe GER disease and that bronchoconstriction severity and duration are related to GER duration. Cuttitta G, Cibella F, Visconti A, Scichilone N, Bellia V, Bonsignore G. Spontaneous gastroesophageal reflux and airway patency during the night in adult asthmatics.




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