Bronchial hyperreactivity in non-atopic children with asthma and reflux: effect of anti-reflux treatment

Pediatr Pulmonol. 2009 Nov;44(11):1070-4. doi: 10.1002/ppul.21094.


Introduction: The prevalence of bronchial hyperreactivity (BHR) or the effect of anti-reflux treatment on BHR in children with asthma and gastroesophageal reflux disease (GERD) is not known.

Methods: Thirty non-atopic children with persistent asthma were studied. Extended esophageal pH monitoring was used to diagnose GERD and methacholine challenge test (MCT) was used as a marker of BHR and performed before and 2 years after anti-GERD treatment.

Results: Of the 21 patients positive for GERD (group A), 15 had positive MCT suggesting BHR. Of the 9 patients negative for GERD (group B), 5 had positive MCT. On repeat testing 2 years later, 11/15 group A patients and 3/5 group B patients tested negative for BHR. Group A patients were receiving fewer asthma medications and experienced fewer exacerbations than Group B patients.

Conclusions: BHR is prevalent in children with asthma and GERD and improves with anti-GERD treatment.

MeSH terms

  • Adolescent
  • Asthma / complications
  • Asthma / epidemiology
  • Asthma / physiopathology*
  • Bronchial Hyperreactivity / complications*
  • Bronchial Hyperreactivity / epidemiology*
  • Bronchial Provocation Tests
  • Child
  • Esophageal pH Monitoring
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / drug therapy*
  • Gastroesophageal Reflux / epidemiology
  • Humans
  • Prevalence
  • Proton Pump Inhibitors / therapeutic use*


  • Proton Pump Inhibitors