Prevalence of gastroesophageal reflux in difficult asthma: relationship to asthma outcome

Chest. 2005 Apr;127(4):1227-31. doi: 10.1378/chest.127.4.1227.


Study objectives: To determine the prevalence of gastroesophageal reflux disease (GERD)-both symptoms and objective evidence-using 24-h dual-probe pH monitoring in difficult asthma, and the relationship between the presence and treatment of GERD to clinical outcome.

Design and setting: As part of a systematic evaluation protocol, 68 subjects with difficult-to-control asthma attending a difficult asthma clinic were referred for dual-probe ambulatory pH esophageal monitoring.

Results: Esophageal probe data were available in 52 patients (76%) with difficult asthma. The prevalence of GERD/GERD-associated asthma symptoms was 75% (39 of 52 patients; 95% confidence interval [CI], 63 to 84.7%). The prevalence of GERD as evidenced by an abnormal pH profile at the distal esophageal probe was 55% (29 of 52 patients; 95% CI, 40 to 69%). The prevalence of GERD at the proximal probe was 34.6% (18 of 52 patients; 95% CI, 23.6 to 51%). The prevalence of GERD was similar in asthmatic subjects who responded to intervention and those who remained difficult to control (therapy resistant). Asymptomatic GERD was present in 9.6% (5 of 52 patients); 16% of cough episodes correlated with acid reflux.

Conclusions: In difficult-to-control asthma, GERD is common, but identification and treatment of GERD do not appear to relate to improvement in asthma control in this population.

MeSH terms

  • Adult
  • Asthma / complications*
  • Asthma / drug therapy
  • Female
  • Gastric Acidity Determination
  • Gastroesophageal Reflux / epidemiology*
  • Gastroesophageal Reflux / etiology*
  • Humans
  • Male
  • Prevalence
  • Treatment Failure