Published online Mar 28, 2015. doi: 10.5320/wjr.v5.i1.58
First decision: January 8, 2015
Revised: January 16, 2015
Accepted: February 9, 2015
Article in press: February 10, 2015
Published online: March 28, 2015
Processing time: 85 Days and 21.4 Hours
The diagnosis of asthma requires the presence of episodic respiratory difficulties characterized by variable and reversible airway obstruction. It has a high prevalence worldwide and is traditionally considered to be an allergic disease. Most cases are responsive to treatment with bronchodilators and anti-inflammatories, as recommended by national and international guidelines; however, approximately 10% of asthmatic patients are refractory even to optimal therapy. Gastroesophageal reflux disease (GERD) is a common disorder in asthmatic patients and the two disorders may be linked pathophysiologically. Here we review data from preliminary studies that suggest asthma could be induced or exacerbated by gastroesophageal reflux. The optimal strategies for the diagnosis of GERD-related asthma and its therapy are still debated. However, there is evidence to suggest that antireflux treatment is effective and practical for asthmatic patients with well-defined reflux disease.
Core tip: Allergic responses have been extensively studied but may be overemphasized for asthma; some asthma is frequently found to be associated with gastroesophageal reflux disease (GERD) rather than “allergy”. That a subgroup of asthma could be induced or exacerbated by gastroesophageal reflux has become consensus. GERD should be assessed in asthmatic patients who also have typical symptoms of GERD, as well as in patients with nonatopic or severe/refractory asthma. The optimal strategies for the diagnosis of GERD-related asthma and its therapy are still being debated. However, there is evidence to suggest that antireflux treatment is effective and practical for asthmatic patients with well-defined reflux disease.