EXERCISE-INDUCED ASTHMA - IS GASTROESOPHAGEAL REFLUX A FACTOR

An acid-induced, cholinergic esophagobronchial reflex has been describ ed whereby acid refluxing into the esophagus causes bronchospasm. Repo rts of exertional gastroesophageal acid reflux prompted us to study th e possibility that exercise-induced asthma (EIA) could be related to g astroesophageal reflux (GER), Following an overnight fast, 10 athletes with a history of EIA (nine men, one woman; mean age 31) were studied , Continuous monitoring of intraesophageal pH and motility, EGG, and a rterial oxygen saturation was done, After baseline monitoring at rest for 15 min, subjects underwent treadmill exercise for 10 min followed by continuous monitoring for 30 min after exercise, Spirometry was don e at baseline prior to exercise, then repeated every 5 min after exerc ise fur 30 min, Two subjects were retested at a later date following a standard test meal, All 10 subjects demonstrated a decrease in FEV, i n response to exercise, but only half met criteria for EIA. Although 6 0% (6/10) showed some evidence of GER, only three subjects demonstrate d a pathologic degree of GER. In the two subjects retested postprandia lly, change in FEV(1) was no different in one and improved in the othe r despite worsening of GER in both, There was no significant correlati on between GER and EIA (P = 0.2). EIA correlated inversely with amplit ude of esophageal contractions (P = 0.029) and was directly related to the percentage of multipeaked contractions and the duration of perist altic contractions (P = 0.08), EIA is not associated with exertional G ER.