A Practical Approach to Gastroesophageal Reflux and Asthma

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Abstract
“New” ideas in medicine are often found to have been recognized by other astute physicians in the past. In this issue, Dr. Mansfield carefully traces the development of the relationships between gastroesophageal reflux and pulmonary diseases (1). My own interests in this subject began in 1973 while working with Dr. Mays (2,3). I arrived in Denver in 1975 and was surprised to discover skepticism concerning the relationships between gastroesophageal reflux and pulmonary conditions (2,3). There were complaints that more carefully controlled prospective studies were needed that would better explain the relationships between gastroesophageal reflux and pulmonary disease. Both asthma and gastroesophageal reflux are common conditions, and coincidental occurrence might be present without either disease influencing the other. Since 1975, numerous studies conducted in this country and abroad have helped to explain the pathophysiology of how gastroesophageal reflux may aggravate asthma. Studies in the human and animal models have suggested a reflex mechanism through esophageal vagal impulses, while other human studies have documented mechanisms of aspiration (1).