Comorbidity and impact of bronchial asthma to gastroesophageal reflux disease in children

Abstract

Gastroesophageal reflux disease (GERD) is a highly comorbid disease with bronchial asthma (BA). The relationship between GERD and BA is complicated and controversial. Aim: to analyze impact factors of BA and GERD in children with comorbid pathology for the further development of early diagnostic and preventive measures. Materials and methods. 81 children (aged 6 to 18 years) were involved in the study and divided into two groups: children with GERD and BA as a main group (n=27) and children with GERD and without allergy as a control group (n=54). The verification of diagnoses was carried out according to the unified clinical protocols of medical care. The results were processed using nonparametric statistical methods. Results. Esophageal motility disorders (EM) were detected in 100% of patients with BA, regardless of the severity. Inflammatory changes of the esophageal mucosa (EM) were equally frequently detected in patients with mild and moderate persistent BA, and were absent in patients with severe BA. GERD was diagnosed in 44.4% of patients with BA. 25.0% of patients had the erosive form of GERD, 25.0% — non-erosive GERD, 50.0% — endoscopically negative GERD, in the control group — 33.0%, 35.0%, 32.0% respectively. Conclusion. All patients with BA had esophageal motility disorders. GERD was diagnosed in 44.4%. Inflammatory changes of EM (erosive and non-erosive forms of GERD) were detected in 22.0% of patients with mild and moderate forms of BA, and in severe forms of BA — endoscopically negative GERD. The frequency of inflammatory changes reached 68.0% in the control group. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution indicated in the work. The informed consent of children's parents was obtained for conducting the studies. No conflict of interests was declared by the authors.