A Case of Gastroesophageal Reflux Disease Who Shows Asthma Symptoms

Han, Kyu Seung; Lee, Soo Jung; Lee, Joon Sung

Abstract

Gastroesophageal reflux(GER) is a common clinical problem, classically manifested by regurgitation or nonprojectile vomiting. Other respiratory manifestations such as chronic cough, asthma, and recurrent pneumonia are being increasingly recognized; the so-called "atypical" or "extraesophageal" manifestations. The relationship between GER and pulmonary complications has been recognized since the 1960s. The association of GER and pulmonary disease is further supported by reports showing the relief of respiratory symptoms and improvement in results of pulmonary function tests after medical or surgical antireflux treatment in asthmatics. Two different mechanisms for GER-associated pulmonary diseases have been postulated :(1) microaspiration of gastric contents into the lung resulting in an inflammatory reaction, the "reflux theory," and (2) activation by GER of a vagal reflex are from the esophagus to the lung resluting in bronchoconstriction, the "reflex theory." Many diagnostic tests have been proposed to evaluate the presence of GER disease. 24-hour-esophageal pH monitoring has been 113ported to have a higher sensitivity and specificity than any other single c1mical test-It is considered as the go1d standard method. We experienced a case of infantile asthma due m GER diagnosed by 24-hour esophageal pH monitoring in seven-month-old infant who presented wheezing and dyspnea. She was much improved clinically and at follow-up pH monitoring for respiratory symptoms and refulx with medical antireflux therapy(cisapride).