[Pulmonary gammagraphy study in asthmatic children with gastroesophageal reflux]

Rev Alerg Mex. Nov-Dec 2008;55(6):229-33.
[Article in Spanish]

Abstract

Background: The asthmatic children who do not respond favorably to the specifically anti-allergic treatment, and also begin their breathlessness crisis preferably at night, are suspicious of suffering gastric-esophagus reflux that stimulate bronchial spasm crisis by means of an aspiration mechanism, or more frequently, by means of a reflective mechanism through the vagal via.

Objectives: To know probable physiopathologic mechanism of gastric-esophagus reflux that exacerbates asthmatic crisis. To know digestive symptoms associated to respiratory process. To evaluate clinic evolution of children after antireflux treatment.

Material and methods: There were chosen 50 moderate-severe persistent asthmatic patients with non favorable evolution and gastric-esophagus reflux. The diagnosis was settled by means of radiological study, with barium contrast in esophagus, stomach and duodenum, and esophagus-pulmonary gammagraphy with technetium 99 (99mTc). Besides, a searching of bronchial aspiration signs with the isotopic exploration was carried out.

Results: It was demonstrated that 38% of all cases had bronchial microaspirations and 30% did not have digestive symptoms associated to the respiratory process. Patients were subjected to an antireflux treatment and 78% of them considerably improved their asthmatic crisis after the treatment.

Conclusions: 38% of the cases showed bronchial microaspirations in pulmonary gammagraphy. The more probable physiopathologic mechanism was vagal via, because 62% of the patients did not have bronchial aspiration signs. There were no digestive symptoms (silent reflux) in 30% of the children. Asthmatic crisis evolved favorably in 78% of the cases after antireflux treatment.

MeSH terms

  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / complications
  • Asthma / diagnostic imaging*
  • Asthma / drug therapy
  • Barium Sulfate
  • Bronchial Spasm / diagnostic imaging*
  • Bronchial Spasm / etiology
  • Child
  • Child, Preschool
  • Colloids
  • Combined Modality Therapy
  • Contrast Media
  • Female
  • Gastroesophageal Reflux / diagnostic imaging*
  • Gastroesophageal Reflux / therapy
  • Humans
  • Infant
  • Lung / diagnostic imaging*
  • Male
  • Radiography
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Respiratory Aspiration / diagnostic imaging*
  • Respiratory Aspiration / etiology
  • Technetium Compounds
  • Tin Compounds
  • Vagus Nerve / physiopathology*

Substances

  • Anti-Asthmatic Agents
  • Colloids
  • Contrast Media
  • Radiopharmaceuticals
  • Technetium Compounds
  • Tin Compounds
  • technetium Tc 99m tin colloid
  • Barium Sulfate