Gastric asthma: A clinical review

Gastroesophageal reflux (GER) is defined as the movement of gastric contents into the esophagus. This material, which may contain acid, pepsin, bile acids and pancreatic enzymes, has the ability to irritate or injure tissues not adapted to the presence of this potentially noxious material. As reflux may proceed more proximal than the esophagus, other tissues may he affected, both clinical and experimental data have demonstrated that these events nay lead to a variety of esophageal, head, neck and pulmonary complications. Pulmonary manifestations of GER have been the focus of the medical literature, for the last two decades, and in particular the association of GER and asthma has been well recognized. The latter was suggested first by Sir William Osler more than a century ago. Nowadays its presence is well known in terms of gastric asthma, but the importance is till a matter of debate. The prevalence of GER among patients with asthma is generally reported to be higher than in normal but with a wide range from 30% to 90% in several reports. The mechanism by which GER might induce asthma has been a subject of diversity. There are two potential mechanisms whereby GER could produce bronchoconstriction and therefore exacerbate airflow obstruction in asthmatics, the evidences for these mechanisms were reviewed in the tex