Influence of gastroesophageal reflux measured by pH-impedance on asthma control degree in children and youth

Aim: To assess the relationship between severity of gastroesophageal reflux (GER) and asthma control degree (AO) in children and youth.

Material and methods : In 74 children and teenagers, aged from 4 to 18 years (average age 11.8 years), 40 males and 34 females with bronchial asthma, including 48 with controlled asthma, 8 with partly controlled asthma and 7 with uncontrolled asthma, 24-h pH-impedance was performed (Sandhill Scientific Inc., USA). Anti-reflux medication was ceased at least 7-10 days before the study.

Results: Acid GER was found together in 31 patients (43.2%), non-acid GER in 6 patients (8.1%), but mixed GER in 19 patients (25.7%). Eighteen patients (24.3%) were found not to suffer from GER. There were a total of 5549 reflux events detected by pH-impedance; 62.4% were characterized as acid and 37.6% as non-acid. There were a total of 1977 proximal reflux events; 68.8% were characterized as acid and 31.2% as non-acid. There were no statistically significant differences between groups with controlled, partly controlled and uncontrolled asthma concerning analysed pH-impedance parameters. Respiratory symptoms reported during the study by only 6 patients included cough (3 patients) and dyspnoea (3 patients). Only in 2 did the symptoms (dyspnoea) correlate with acid reflux episodes.

Conclusions : The majority of children with asthma do have GER, most often acid or mixed GER. There is no relationship between the severity of GER and the degree of asthma control. There are many full-column reflux episodes in children and youth with asthma, but they have no impact on the asthma control degree. The analysis of the cause-and-effect relationship between GER and asthma in children and youth is difficult because of the small number of symptoms recorded during the pH-impedance monitoring and the small number of symptoms correlated with reflux.