This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zerbib, F. Articles by Tunon-de-Lara, J. M. Search for Related Content PubMed PubMed Citation Articles by Zerbib, F. Articles by Tunon-de-Lara, J. M.

Effects of Bronchial Obstruction on Lower Esophageal Sphincter Motility and Gastroesophageal Reflux in Patients with Asthma

Service d'Hépato-gastroentérologie, Hôpital Saint-André, Bordeaux; Service des Maladies Respiratoires, Hôpital du Haut-Lévêque, Pessac; INSERM U 539, CHU Hôtel Dieu, Nantes; and INSERM E9937, Université Victor Segalen Bordeaux 2, Bordeaux, France

Correspondence and requests for reprints should be addressed to Frank Zerbib, M.D., Ph.D., Service d'Hépato-gastroentérologie, Hôpital Saint-André, F-33075 Bordeaux Cédex, France. E-mail: frank.zerbib{at}chu-bordeaux.fr

The relationship between gastroesophageal reflux and asthma remains unclear. The aim of this study was to analyze the effect of bronchial obstruction on lower esophageal sphincter (LES) motility and reflux in patients with asthma. LES motility and esophageal pH were assessed in eight subjects with intermittent asthma and eight healthy volunteers during three consecutive 30-minute periods: baseline, methacholine-induced bronchospasm, and after inhalation of the ß2-agonist salbutamol. Healthy subjects inhaled 2 mg of methacholine, whereas subjects with asthma inhaled the dose of methacholine causing a 15% fall in FEV₁, as determined by a previous methacholine challenge. LES motility, esophageal pH, and FEV₁ were not significantly different between the three periods in healthy subjects. In patients with asthma, methacholine induced a 21.9 ± 2.6% decrease in FEV₁ and a concomitant increase in the rate of transient LES relaxation (TLESR) and reflux episodes. Inhalation of salbutamol decreased the rate of TLESRs but not the number of reflux episodes. We conclude that in patients with asthma, methacholine-induced bronchospasm increases the rate of TLESR and the number of reflux episodes. These results support the belief that, in asthma, bronchial obstruction may be responsible for reflux or may aggravate reflux through a mechanism that remains to be further clarified.

Key Words: asthma • gastroesophageal reflux • lower esophageal sphincter • bronchoconstriction • manometry

This article has been cited by other articles:

				D Sifrim, L Dupont, K Blondeau, X Zhang, J Tack, and J Janssens Weakly acidic reflux in patients with chronic unexplained cough during 24 hour pressure, pH, and impedance monitoring Gut, April 1, 2005; 54(4): 449 - 454. [Abstract] [Full Text] [PDF]

				T. O. Kiljander and J. O. Laitinen The Prevalence of Gastroesophageal Reflux Disease in Adult Asthmatics Chest, November 1, 2004; 126(5): 1490 - 1494. [Abstract] [Full Text] [PDF]

				M.I. Gunnbjornsdottir, E. Omenaas, T. Gislason, E. Norrman, A-C. Olin, R. Jogi, E.J. Jensen, E. Lindberg, E. Bjornsson, K. Franklin, et al. Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms Eur. Respir. J., July 1, 2004; 24(1): 116 - 121. [Abstract] [Full Text] [PDF]

				M. J. Tobin Asthma, Airway Biology, and Nasal Disorders in AJRCCM 2002 Am. J. Respir. Crit. Care Med., February 1, 2003; 167(3): 319 - 332. [Full Text] [PDF]