Document Detail


Gastroesophageal reflux, asthma, and mechanisms of interaction.
MedLine Citation:
PMID:  11749917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Gastroesophageal reflux (GER) is a potential trigger of asthma. The esophagus and lung interact through a variety of mechanisms. Esophageal acid-induced bronchoconstriction can be provoked by a vagally mediated reflex, whereby acid in the distal esophagus produces airway responses; by neural enhancement of bronchial reactivity, whereby esophageal acid augments airway hyperresponsiveness; or by microaspiration, in which small amounts of esophageal acid in the upper airway cause significant airway responses. Interestingly, even in the microaspiration model, the vagus nerve plays a significant role. Neurogenic inflammation in the lung may occur with either vagally mediated mechanisms or with microaspiration. The prevalence of reflux symptoms, esophagitis, and abnormal esophageal acid contact time is higher in patients with asthma than in control populations. Potential mechanisms, whereby asthma may predispose to the development of GER, include autonomic dysregulation, an increased pressure gradient differential between the thorax and the abdomen, a high prevalence of hiatal hernia, alterations in crural diaphragm function, and bronchodilator medication use. Further research will help define how the esophagus and lung interact.
Authors:
S M Harding
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  The American journal of medicine     Volume:  111 Suppl 8A     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-12-25     Completed Date:  2002-01-14     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  8S-12S     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, 1900 University Blvd., THT-Room 215, Birmingham, AL 35294, USA.
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MeSH Terms
Descriptor/Qualifier:
Asthma / diagnosis,  epidemiology*
Comorbidity
Female
Gastroesophageal Reflux / diagnosis,  epidemiology*
Humans
Male
Prevalence
Prognosis
Risk Assessment
Risk Factors
Grant Support
ID/Acronym/Agency:
HL 03633/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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