Children who suffer from both asthma and gastroesophageal reflux disease (GERD) may require fewer asthma medications after receiving anti-GERD treatment, says a study published in the April issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP). The study found that medically or surgically treating GERD in children with asthma reduced the need for total asthma medications by more than 50 percent.
The study, conducted at West Jefferson Medical Center, is the first of its kind to evaluate the effect of anti-GERD treatment using acid suppressing drugs called proton pump inhibitors (PPIs) on the requirement for asthma medications in older children with persistent moderate asthma. Forty-six asthma patients, ages 5-11, were selected for the study, based on predetermined criteria, including the need for standard asthma medications such as bronchodilators, leukotriene antagonists, and corticosteroids. Upon evaluation, 27 patients showed evidence of GERD and received either medical or surgical anti-GERD treatment.
During 12 months of observation, all patients with GERD receiving anti-GERD treatment showed a more than 50 percent reduction in total asthma medications used, and specifically, a more than 50 percent reduction in bronchodilator use. In addition, 89 percent of patients with GERD required no treatment with inhaled corticosteroids, and no patients required use of leukotriene antagonists during the final six months of observation. Patients receiving no anti-GERD treatment showed no change in the use of total asthma medications.
Of the patients with GERD, 18 underwent medical anti-GERD treatment for six months using PPIs and lifestyle changes, and nine patients chose surgical treatment. For patients without GERD, eight patients opted to receive a therapeutic trial of anti-GERD treatment, while the remaining 11 patients received no anti-GERD treatment. Patients served as their own control over asthma medications but were assessed by a physician for six months prior to anti-GERD treatment and for 12 months posttreatment.
CHEST is a peer-reviewed journal published by the ACCP. It is available online each month at http://www.chestjournal.org. ACCP represents more than 15,000 members who provide clinical, respiratory, and cardiothoracic patient care in the U.S. and throughout the world. ACCP's mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication.