Gastroesophageal reflux: a potential asthma trigger

Immunol Allergy Clin North Am. 2005 Feb;25(1):131-48. doi: 10.1016/j.iac.2004.09.006.


Gastroesophageal reflux (GER) is a potential trigger of asthma. Approximately 77% of asthmatics report heartburn. GER is a risk factor for asthma-related hospitalization and oral steroid burst use. Asthmatics may be predisposed to GER development because of a high prevalence of hiatal hernia and autonomic dysregulation and an increased pressure gradient between the abdominal cavity and the thorax, over-riding the lower esophageal sphincter pressure barrier. Asthma medications may potentiate GER. Potential mechanisms of esophageal acid-induced bronchoconstriction include a vagally mediated reflex, local axonal reflexes, heightened bronchial reactivity, and microaspiration, all resulting in neurogenic inflammation. Anti-reflux therapy improves asthma symptoms in approximately 70% of asthmatics with GER. A 3-month empiric trial of twice-daily proton pump inhibitor given 30 to 60 minutes before breakfast and dinner can identify asthmatics who have GER as a trigger of their asthma.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Asthma / etiology*
  • Asthma / physiopathology*
  • Bronchoconstriction
  • Enzyme Inhibitors / therapeutic use
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / epidemiology
  • Hospitalization
  • Humans
  • Inflammation
  • Prevalence
  • Proton Pump Inhibitors
  • Risk Factors


  • Enzyme Inhibitors
  • Proton Pump Inhibitors