THE RELATIONSHIP OF GASTROESOPHAGEAL REFLUX TO NOCTURNAL WHEEZING IN CHILDREN WITH ASTHMA

  • 1 January 1982
    • journal article
    • research article
    • Vol. 49  (6) , 318-322
Abstract
Gastroesophageal reflux (GER) has been reported in a high percentage of children with asthma. To investigate the relationship between GER and nocturnal asthma (NA), 25 pediatric patients with histories of NA were studied prospectively with 3-13 wk of in-patient observation to document NA and quantitate day-time and night-time wheezing frequency. Two distinct groups of patients were identified as follows: 17 patients with predominant day-time asthma (DA) and 8 with prominent NA. All were studied with overnight esophageal pH recordings to detect GER during sleep while also monitoring clinical status. A reflux score (RS) was calculated to quantitate the severity of GER. Of 25 patients, 16 (64%) had abnormal GER, including all 8 patients with NA. A significant positive correlation was found between the RS and the percentage of nights with wheezing, while age, serum theophylline level and pulmonary function at the time of study did not correlate with RS. The NA group also had significantly higher RS than the DA group. Of the 8 NA patients, 3 had the onset of clinical wheezing during an episode of GER. There is a significant association between NA and GER independent of age, lung function and theophylline levels. GER may induce NA in a subpopulation of patients with reactive airways.