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Risk of Gastro-Esophageal Reflux Disease in Bronchial Asthma-A Prospective Study Using FSSG Scale and Gastroesophageal Endoscopy

Gajanan S Gaude, Jyothi Hattiholi, Giriraj Bhoma and Santosh Hajare

Background: Gastro-esophageal reflux disease (GERD) is a chronic disorder of the upper gastrointestinal tract with global distribution. GERD often coexists with asthma and is often responsible for the repeated exacerbations. In India, there is limited data on the exact prevalence of GERD in bronchial asthma. Objective: To investigate the prevalence of GERD in adult patients with bronchial asthma.

Materials and Methods: A total of 60 patients with confirmed diagnosis of bronchial asthma underwent assessment for GERD with the frequency scale for the symptoms of GERD (FSSG) Questionnaire. A score of 8 and above was taken as positive for GERD. Then confirmation of GERD was done by Gastro-esophageal endoscopy in all GERD positive cases. Grading of GERD was done with endoscopy report according to Los Angeles grading. FSSG score was evaluated in detail and the risk factors were analyzed.

Results: The prevalence of GERD in bronchial asthma patients was 40%. It was observed that by using FSSG questionnaire, there was predominance of regurgitation related symptoms (89%) as compared to other symptoms in bronchial asthma patients. Dysmotility-related symptoms were observed in 53% of the cases. As the severity of the diseases increased, the severity of GERD also increased as assessed by Los Angeles grading.

Conclusions: According to the current study, more than one-third of adult patients with asthma had GERD, and this can contribute to the repeated exacerbations in bronchial asthma patients. Thus the high suspicion is required in these cases for the adequate control of bronchial asthma.