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Gastroesophageal reflux disease and childhood asthma.
MedLine Citation:
PMID:  23197288     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Gastroesophageal reflux disease (GERD) is common in children with asthma and may be present with or without symptoms. Clinicians, influenced by position statements in national guidelines, have routinely treated children with poorly controlled asthma with various anti-GERD medications. This practice is based on the pervasive but unproven belief that GERD is an important determinant of poor asthma control.
RECENT FINDINGS: Clinical studies show that GERD is highly prevalent in children with asthma, with estimates as high as 80%, but nearly half of the children are asymptomatic. However, there is no conclusive evidence per se that asymptomatic GERD informs asthma control, and treatment of GERD in the few controlled trials available for review does not substantively improve asthma outcomes. In a recent large controlled clinical trial, treatment with a proton-pump inhibitor (PPI) was not only ineffective, but adverse effects were common, including an increased prevalence of symptomatic respiratory infections.
SUMMARY: Current evidence does not support the routine use of anti-GERD medications in the treatment of poorly controlled asthma of childhood. However large controlled trials of children symptomatic of both GERD and asthma have not been conducted, and in this case the benefits of treatment, although unproven, might outweigh the risks.
Authors:
Kathryn Blake; William G Teague
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in pulmonary medicine     Volume:  19     ISSN:  1531-6971     ISO Abbreviation:  Curr Opin Pulm Med     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-11-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503765     Medline TA:  Curr Opin Pulm Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  24-9     Citation Subset:  IM    
Affiliation:
aBiomedical Research Department, Center for Pharmacogenomics and Translational Research, Nemours Children's Clinic Jacksonville, Florida bDivision of Pediatric, Respiratory Medicine and Allergy, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
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