JAMA · 1976 · 173 citations · 0 references
MedicineInternal MedicineSurgeryAllergyGastroenterologyPulmonologyAsthma ManagementEsophageal DiseasesGastroesophageal Reflux DiseaseGastrointestinal SurgeryAnti-reflux SurgeryAspiration Of Gastric ContentsGastric Acid-base BalanceGastroesophageal Reflux EvaluationLower Esophageal Sphincter DysfunctionRefractory AsthmaSevere Asthma ManagementSevere Asthma Treatment
Of 28 patients with severe asthma routinely examined with upper gastrointestinal (UGI) x-ray films, 18 (64%) were found to have hiatus hernia and 13 (46%) were found to have demonstrable gastroesophageal reflux. These prevalences differed significantly (<i>P</i><.001) from those seen in a control population (19% and 5%, respectively). These data suggest that aspiration of gastric acid is a frequent incitant to severe asthma and that it should be routinely sought in the treatment-resisant asthmatic patient. Intensive medical regimens directed against reflux and acidity may bring notable improvement in asthma symptoms. Surgical restoration of effective lower esophageal sphincter function has proved to be curative in other reported studies. (<i>JAMA</i>236:2626-2628, 1976)