To investigate the prevalence of gastroesophageal reflux (GER) among adult asthmatics and to study the effect of omeprazole therapy on the outcome of asthma in asthmatics with GER
In this double blind, placebo-controlled crossover study, 100 asthma patients meeting the criteria of the American Thoracic Society were enrolled. Ambulatory pH monitoring was done to find the prevalence of GER and the patients who were found to have GER were randomized to receive omeprazole 40 mg qd, or placebo for 8 weeks. After a 2 week washout period, the patients were crossed over to the other treatment. Spirometry was performed at baseline and immediately after both treatment periods. Peak expiratory flow rates (PEFR) and the pulmonary and gastric symptoms were recorded daily in a diary.
Significant GER was found in 58% of the study group. There was significant reduction in mean weekly daytime asthma symptom score (13.68±2.37 to 11.65±1.79, p<0.05) as well as night-time asthma symptom score (13.52±1.65 to 10.56±1.51, p<0.01) after omeprazole therapy. Based on the symptom scores, 40% of the patients were regarded as responders to omeprazole treatment. There was significant improvement in PEFR (70.15±10.12 to 81.39±12.56, p<0.01) but no improvement in FEV1 (72.11±29.16 to 73.44±30.81, p=0.14) after omeprazole treatment.CONCLUSIONS: Asthmatics have high prevalence of GER. Antireflux treatment improves asthma symptoms as well as PEFR in asthmatics with GER.
GER may contribute to asthma symptoms in some asthmatics. Antireflux therapy may have a beneficial effect on asthma outcome in these patients.
B. Sharma, None.