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Children's Asthma Not Eased by Anti-Reflux Drug


Asthma is a chronic disorder that makes it difficult to breathe. Acid reflux is a condition in which stomach acids leak upward and irritate the esophagus. Two very different medical problems, but for some reason they often go together, making a difficult situation worse. Studies have shown that treating acid reflux in adults helps reduce the severity of their asthma attacks. Researchers wanted to find out if the same would hold true for children.

Seventeen-year-old Alaina Kvapil was diagnosed with asthma when she was 13.

“When you have an asthma attack, your airways actually close up and people don’t realize that you can’t breathe, you can’t get the air out,” Kvapil said.

The World Health Organization says asthma is the most common chronic disease among children. No one knows exactly why, but studies show a link between asthma and acid reflux disease. Up to 70 percent of people with asthma have gastroesophageal reflux disease, or GERD, which occurs when food and stomach acids leak back up into the esophagus, the tube that connects the mouth to the stomach.

Children and babies can suffer from gastroesophageal reflux disease. In children, as in adults, the most common symptom is heartburn.

Alaina Kvapil participated in a study to see if treating her acid reflux disease would also treat her asthma. She was one of more than 300 children who participated in the study. The study involved treating some of the children with powerful drugs called proton pump inhibitors, which reduce the amount of acid in the stomach.

Dr. Janet Holbrook from Johns Hopkins School of Public Health is one of the study's co-authors. “This study is important because proton pump inhibitors are widely used drugs and there’s been a lot of conflicting data about whether they’re effective for the treatment of asthma," Holbrook said.

Half of the children were given a proton pump inhibitor, or PPI, along with an inhaled steroid that helps with breathing and digestive problems. The other half were given a placebo.

Although medication that treats acid reflux disease often helps to relieve asthma symptoms, the children without acid reflux symptoms who took PPIs did not see any reduction in their asthma symptoms. In fact, the drugs were shown to do some harm.

"In the children who were taking the active drug they tended to have more upper respiratory infections during the study. So not only is the treatment not effective...it may also come with some risk,” Holbrook said.

Even in the children who had documented acid reflux, the PPI did not help their asthma symptoms.

The American Lung Association helped support the study. Journal of the American Medical Association published its findings.

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