Surgical treatment of gastroesophageal reflux in ten patients with severe asthma

Respiration. 1989;56(1-2):110-5. doi: 10.1159/000195785.

Abstract

The surgical cure of gastroesophageal reflux was investigated in 10 asthmatic adults with a mean post-operative follow-up period of 21 months. The patients had severe asthma, and gastroesophageal reflux confirmed by 3-hour post-prandial pH monitoring. Medical treatment for reflux was effective on the clinical signs of the reflux but ineffective on the respiratory signs. The clinical course of the asthma, and 3-hour post-prandial pH monitoring were evaluated before 3, 6, and after 6 months. The reflux was cured by surgery in 8 cases, and improved in two. Immediate post-operative surveillance of the asthma revealed no cure. There were three immediate failures, and two recurrences before 6 months post-operative. Improvement was stable beyond 6 months in 5 patients (suppression or 80% reduction of corticosteroids in 3 cases, considerable reduction in the use of bronchodilators in 2 cases). Our results suggest that the surgical treatment of gastroesophageal reflux may be useful, at least for suppressing an aggravating factor in the respiratory illness.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Anti-Ulcer Agents / therapeutic use
  • Asthma / complications*
  • Asthma / drug therapy
  • Asthma / physiopathology
  • Bronchodilator Agents / therapeutic use
  • Dyspnea / drug therapy
  • Dyspnea / physiopathology
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume / physiology
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / drug therapy
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Middle Aged
  • Recurrence
  • Total Lung Capacity / physiology

Substances

  • Anti-Ulcer Agents
  • Bronchodilator Agents