PREVALENCE OF GASTROESOPHAGEAL REFLUX SYMPTOMS IN ASTHMA

Study objective: To determine the prevalences of symptomatic gastroeso phageal reflux (GER), reflux-associated respiratory symptoms (RARS), a nd reflux-associated beta-agonist inhaler use in asthmatics. Design: Q uestionnaire-based, cross-sectional analytic survey. Setting: Outpatie nt asthma and clinical research clinics attached to the University of Calgary tertiary care centre and two family practices. Patients: Asthm a group consisted of 109 patients referred to an outpatient asthma cli nic. First control group consisted of 68 patients visiting their famil y physicians. Second control group consisted of 67 patients with thyro id disease, hypercholesterolemia, or diabetes participating in drug tr ials. Results: Among the asthmatics, 77%, 55%, and 24% experienced hea rtburn, regurgitation, and swallowing difficulties, respectively. Symp toms were less prevalent in the control groups. At least one antireflu x medication was required by 37% of asthmatics (p<0.001, vs controls). None of the asthma medications were associated with an increased like lihood of symptomatic GER, In the meek prior to completing the questio nnaire, 41% of the asthmatics noted RARS, including cough, dyspnea, an d wheeze and 28% used their inhalers while experiencing GER symptoms. Inhaler use correlated with the severity of heartburn (r=0.28, p<0.05) and regurgitation (r=0.40, p<0.05). Conclusions: The questionnaire de monstrated a greater prevalence of GER symptoms, RARS, and reflux-asso ciated inhaler use in asthmatics. This excessive inhaler use may expla in how GER indirectly causes asthma to worsen.