24-h esophageal pH testing in asthmatics - Respiratory symptom correlationwith esophageal acid events

Background: Gastroesophageal reflux (GER) may be a trigger for asthma and m ay be clinically silent, Twenty-four-hour esophageal pH testing accurately diagnoses GER in asthmatics, There are no reports correlating respiratory s ymptoms with esophageal acid events. This study examines the prevalence and severity of GER in asthmatics with and without reflux symptoms and examine s respiratory symptom correlation with esophageal acid. Methods: All esophageal manometry and 24-h esophageal pH tests performed we re reviewed in asthmatics who met entrance criteria from July 1, 1989, thro ugh November 1, 1994, GER was present if esophageal pH tests were abnormal. Results of esophageal tests were compared for asthmatics with reflux sympt oms and GER and asthmatics without reflux symptoms and GER. Respiratory sym ptoms correlated with esophageal acid events if the esophageal pH was < 4 s imultaneously with the respiratory event or within 5 min before its onset, Results: Of 199 asthmatics who qualified for analysis, 164 (82%) had reflux symptoms. The results of 24-h esophageal pH tests were abnormal in 118 of 164 asthmatics with reflux symptoms (72%), compared with 10 of 35 asthmatic s without reflux symptoms (29%). Among asthmatics with GER, 119 of 151 resp iratory symptoms (78.8%) were associated with esophageal acid, Seventy-six of 84 reported coughs (90.5%) were associated with esophageal acid. Theophy lline did not alter esophageal parameters. Conclusions: There is a strong correlation between esophageal acid events a nd respiratory symptoms in asthmatics with GER. Respiratory symptom correla tion with esophageal acid events further supports that GER may be a bigger for asthma.