The association between respiratory symptoms and gastro-oesophageal reflux events
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Date
2009
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Research Symposium 2009 - Faculty of Graduate Studies, University of Kelaniya
Abstract
Introduction: The oesophagus and the airways have a common origin. Abnormal gastroooesophageal
reflux (GOR) may predispose to genesis of respiratory symptoms. This association has not been
reported previously in Sri Lanka.
Aims: To describe the association between reflux events and respiratory symptoms in a cohort of
adult asthmatics in Sri Lanka.
Methods: 30 stable, mild asthmatics (American Thoracic Society criteria) underwent dual-sensor
oesophageal pH monitoring. Respiratory symptoms (cough, wheeze, difficulty in breathing, chest
tightness) experienced during monitoring were recorded. Respiratory symptoms were correlated
with reflux events by reviewing diary events and oesophageal pH tracings. A reflux episode was
defined as a drop in pH to values <4 lasting> 4 seconds. A respiratory symptom was considered as
associated with a reflux episode if it occurred 2 minutes prior to or after a reflux episode.
Results: 50% of the asthmatics complained of one or more respiratory symptoms during the 24-
hour recording period. Of 102 respiratory symptoms recorded, 73 were cough, 23 were wheezing
and 5 were episodes of chest tightness. None experienced difficulty in breathing. 93% of coughs,
81 % of wheezes and all episodes of chest tightness were reflux-associated. In most cases reflux
episodes preceded respiratory symptoms. There was no statistically significant difference in any
oesophageal monitoring parameter between asthmatics with and without respiratory symptoms.
Conclusion: Asthmatics experience respira~ory symptoms during reflux events. The deve:lopment
of respiratory symptoms during an episode of acid reflux or within 2 minutes thereafter suggests
that it is probably GOR that triggers asthma.
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Research Symposium; 2009 :153p