ESOPHAGEAL REFLUX AND ASTHMA

Asthma and gastro-oesophageal reflux commonly occur together but the a ssociation in any individual may or may not be causal. Aspiration of g astric acid into the trachea has been demonstrated in some patients wi th asthma with concomitant falls in lung function, while acid in the l ower oesophagus can exacerbate asthma by a vagal reflex following stim ulation of lower oesophageal receptors, Conversely, asthma can lead to worsening reflux both through the use of smooth muscle relaxing anti- asthma medication and by the mechanical effects of hyperinflation redu cing lower oesophageal sphincter pressures, The effects on asthma foll owing treatment of reflux has been anecdotally reported to be successf ul in some individuals, particularly those with severe reflux, but sur gery should be reserved for individuals only after failure of medical treatment and should be aimed at improving reflux symptoms rather than improving asthma control.