Gastroesophageal Asthma*

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Abstract
The case is presented of an elderly woman with severe recurrent attacks of asthma refractory to vigorous medical treatment. A careful history revealed that the attacks chiefly occurred at night and awakened the patient. An x‐ray (barium) examination showed only a small hiatal hernia, but an additional water siphonage test demonstrated a large amount of gastroesophageal reflux which could cause aspiration when the patient was in the horizontal position. After repair of the hernia, the reflux stopped and all respiratory symptoms disappeared. For cases such as this, the term “gastroesophageal asthma” is suggested. Early identification is important as it is a potentially curable form of respiratory disease. It should always be considered in the differential diagnosis, particularly in elderly patients.

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