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Gastroesophageal Reflux Disease in Children with Asthma

Treatment Implications

  • Therapy In Practice
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Abstract

An association between asthma and gastroesophageal reflux disease (GERD) has long been recognized both mechanistically and epidemiologically. The clinical relevance of this interplay continues to be explored, with special interest given to the role of GERD in the worsening of asthma. The effect of GERD is most frequently contemplated in patients with asthma that is difficult to control.

Medical and surgical anti-reflux trials attempting to alter asthma symptoms have reported mixed but generally underwhelming results, although asthma symptom scores are generally improved following effective treatment of GERD. Many of the pharmaceutical studies can be criticised for having too short a duration or for likely incomplete acid suppression.

Few trials have specifically studied pediatric populations. Because GERD is a common condition, particularly in young children, the role reflux plays in the worsening of asthma symptoms and the potential benefit on asthma of anti-reflux therapy warrants further exploration. Whether or not treating symptomatic GERD reduces the symptoms and severity of asthma in children, GERD coexisting with asthma should be aggressively treated. GERD symptoms in most patients with or without asthma can be controlled medically with continuous use of proton pump inhibitors such as omeprazole and lansoprazole and to a lesser extent by histamine H2 receptor antagonists such as famotidine and cimetidine.

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Acknowledgments

Dr Canning’s research is supported financially through grants provided by the National Institutes of Health/National Heart, Lung and Blood Institute. Dr Canning is a consultant for GlaxoSmithKline and UCB Research, has collaborated with investigators from AstraZeneca, Sepracor, and Amgen, and has previously served as a consultant for Merck, Altana, and Sanofi-Aventis. Dr Scarupa is a consultant for Genentech and Sanofi-Aventis Pharmaceuticals. He is also an investigator or sub-investigator in collaborative studies with GlaxoSmithKline, Altana, AstraZeneca, Dyax, Dynavax, Pfizer, and Novartis Pharmaceuticals. The authors do not have investments in nor patents held with any person or group within the pharmaceutical industry.

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  1. Maryland Institute for Asthma and Allergy, Wheaton, Maryland, USA

    Mark D. Scarupa

  2. Johns Hopkins Asthma and Allergy Center, 5501 Hopkins Bayview Circle, Room 3A.24, Baltimore, Maryland, 21224, USA

    Nanako Mori &  Brendan J. Canning

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  1. Mark D. Scarupa
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Correspondence to Brendan J. Canning.

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Scarupa, M.D., Mori, N. & Canning, B.J. Gastroesophageal Reflux Disease in Children with Asthma. Pediatr-Drugs 7, 177–186 (2005). https://doi.org/10.2165/00148581-200507030-00004

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