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.