Spontaneous gastroesophageal reflux and airway patency during the night inadult asthmatics

Controversies still exist on the role of nighttime gastroesophageal reflux (GER) in precipitating nocturnal asthma. We tested the relationship between GER and nocturnal bronchoconstriction by continuously and simultaneously m onitoring both respiratory resistances and esophageal pH in seven asthmatic s with moderate to severe GER disease. Twenty-nine GER episodes were found during the study night lasting more than 5 min (LGER) and 72 not longer tha n 5 min (SGER). Both long (LGER) and short (SGER) gastroesophageal refluxes were able to maintain significantly higher lower respiratory resistances ( RLR) at the resolution of each GER episode (RLRe) With respect to baseline values. RLR, expressed as the area under the RLR curve along each GER episo de (AUCR(LR)) and as RLRe, showed significant correlations with GER duratio n. Moreover, a significant correlation was found between RLR measured 10 mi n after GER resolution and GER duration during each episode. We conclude th at GER itself is able to elicit nocturnal bronchoconstriction in asthmatics with moderate to severe GER disease and that bronchoconstriction severity and duration are related to GER duration.