Abstract
Background: Gastroesophageal reflux (GER) is often related to recurrent respiratory symptoms. Whether GER accounty for exercise-induced bronchoconstriction remains underdebate.
Aims: To compare the gastroesophageal acidity (GE pH) with lung function during exercise in children with recurrent respiratory symptoms.
Methods: In 12 asthmatic and 9 non-asthmatic (aged 5.9 -15.8 yr, M/F 14/7) we assessed spirometry, then started a 24-h GE pH monitoring (GE pH24). In a second session, they did a 6-minutes treadmil-exercise testing followed one hour later by gastroesophageal catheter removal. Prick test and blood samples for IgE and leukocytes were also measured, the sum of allergen-skin wheals was termed “prick index”.
Results: Median (IQR) GE pH24 values were found unrelated to post-exercise FEV1 decrease. GE pH24 correlated with prick index (r=0.58), percent blood eosinophils (r=0.58) only in asthmatic children (p< 0.05); they also yielded higher GE pH24 than non-asthmatic children (7.25, IQR 0.18 vs 7.0, IQR 0.50; p< 0.05). GE pH recorded 6 minutes before exercise decreased during exercise testing from 7.85 (IQR 0.73) to 7.30 (IQR 1.05) in asthmatic (p=0.059) while increased from 7.20 (IQR 0.90) to 7.90 (IQR 0.85) in non-asthmatic children (p=0.043). One-hour post-exercise GE pH increased only in asthmatic children ( 7.80, IQR 0.68; p< 0.05).
Conclusion: Exercise-induced changes of GE pH in asmathic children are presumably related to vagal-induced mechanisms. These mechanisms seems to be enhanced by atopic inflammation.
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Pacchiarotti, C., Barreto, M., Casini, C. et al. Exercise Induced Changes of Gastroesophageal Acidity in Children. Pediatr Res 70 (Suppl 5), 541 (2011). https://doi.org/10.1038/pr.2011.766
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DOI: https://doi.org/10.1038/pr.2011.766