AB 77. Effect of Proton Pump Inhibitors (PPIs) in asthmatics with gastroesophageal reflux disease (GERD)

Background: The objective of this study was to investigate the presence of esophagitis in patients with asthma and GERD and to assess the effect of PPIs on pulmonary function.

Patients and methods: 44 patients with asthma and typical esophageal GERD symptoms (heartburn and/or regurgitation) were enrolled. All patients were underwent upper gastrointestinal endoscopy and the presence of esophagitis was recorded. Patients were classified in two groups, according to the presence or absence of reflux esophagitis. Peak Expiratory Flow Rate (PEFR) was measured and then all patients began treatment with a double dose PPI (omeprazole 20 mg bid) for three months. PEFR was measured again at the end of the 3-month period. Response to treatment was defined a priori as positive if PEFR increased at least by >20%.

Results: 44 patients (mean age 46±12 years, 24 women, 20 men) were investigated. 19 out of 44 patients (43.18%) had endoscopic findings of reflux esophagitis and 25 patients (56.82%) had normal findings. Among the esophagitis group, 4 out of 19 patients (21.05%) responded positively at the end of the 3-month treatment with the PPIs (PEFR increase >20%). Among the non-esophagitis group, 5 out of 25 patients (20%) improved their PEFR >20%. The difference between the two groups regarding positive response to PPI treatment was non significant (P=0.71).

Conclusions: PPI treatment may improve pulmonary function in some patients with asthma and typical esophageal GERD symptoms. The presence or absence of reflux esophagitis does not seem to influence this response.