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The most recent version of this article was published on 1 October 2008

Br J Sports Med. Published Online First: 1 June 2007. doi:10.1136/bjsm.2006.034983
Copyright © 2007 BMJ Publishing Group Ltd & British Association of Sport and Exercise Medicine.

Paper

Acid reflux into the esophagus does not influence exercise-induced airway narrowing in bronchial asthma

Marcello Ferrari 1, Francesco Bonella 1*, Luigi Benini 1, Pietro Ferrari 1, Fosca De Iorio 1, Renato Testi 1 and Vincenzo Lo Cascio 1

1 University of Verona, Italy

* To whom correspondence should be addressed. E-mail: francesco.bonella{at}libero.it.

Accepted 14 May 2007


Abstract

Objectives: Few studies on small patient series have investigated the relationship between gastroesophageal reflux and bronchial responsiveness as expressed by exercise-induced bronchoconstriction (EIB) with non conclusive results. Aim of the study was to evaluate whether the presence of acid in oesophagus may influence EIB.

Methods: Forty five patients with bronchial asthma underwent spirometry, exercise challenge on bicycle ergometer and 24-hours oesophageal pH-monitoring. Subjects with EIB [FEV 1 percentage decreased after exercise({Delta}FEV1) ≥15%, n 28] were retested after a two week treatment course with omeprazole 40 mg/daily. Exercise at baseline was performed at the same time of oesophageal pH monitoring.

Results: In basal condition, there was no difference in FEV1, acid exposure time, number of refluxes measured during 24h pH monitoring, between patients with or without EIB. There was no relationship between spirometry results and {Delta}FEV1 on one hand, and parameters of gastroesophageal reflux on the other. Nine patients with EIB (31.0%) and 6 out of patients without EIB (37.5%) had one or more episodes of GER during exercise challenge, without significant differences between the two groups. After gastric acid inhibition by omeprazole, {Delta}FEV1 did not change significantly.

Conclusions: Our results indicate that acid in oesophagus or its short term inhibition by proton pump inhibitors, has no influence on exercise-induced bronchoconstriction.

Key Words: asthma, bronchospasm, exercise, gastroesophageal reflux


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Commentary on âAcid reflux into the oesophagus does not influence exercise-induced airway narrowing in bronchial asthmaâ
C C Randolph
Br. J. Sports Med. 2008 42: 849-850. [Extract] [Full Text] [PDF]

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