PEDIATRICS Vol. 63 No. 2 February 1979, pp. 207-212
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Gastroesophageal Reflux in Steroid-Dependent Asthmatic Youths

Gail G. Shapiro M.D.1 and Dennis L. Christie M.D.1

1 Department of Pediatrics, University of Washington School of Medicine, the Division of Allergy, Children's Orthopedic Hospital and Medical Center, and the Section of Pediatric Gastroenterology, The Mason Clinic, Seattle

The aims of this study were to evaluate the incidence of gastroesophageal reflux (GER) in chronic allergic steroid-dependent asthmatic children and to assess whether a medical antireflux regimen might improve pulmonary status of asthmatics found to have reflux. Nineteen patients had a determination of lower esophageal sphincter (LES) pressure, pH assessment after acid instillation into the stomach (acid reflux test), and esophagram. After the reflux evaluation, an antireflux regimen was instituted for three weeks; patients were followed with asthma symptom diaries and weekly pulmonary function tests for this period and for another three weeks after finishing the regimen. Gastroesophageal reflux, diagnosed by positive acid reflux test, occurred in nine patients. Five patients had low LES pressure (le12 mm Hg), and two patients had an abnormal esophagram. There were no significant changes in asthma syniptoms or pulmonary function tests with the medical antireflux regimen. Although GER does exist in a high percentage of this patient sample (47%), a short-term antacid and positional antireflux regimen does not improve the pulmonary status of these patients.

Submitted on February 14, 1978
Accepted on July 21, 1978




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