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(ΔFEV1) ≥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 ΔFEV1 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, ΔFEV1 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.