Asthma and Gastroesophageal Reflux: Fundoplication Decreases Need for Systemic Corticosteroids

Hadar Spivak, C. Daniel Smith, Alounthith Phichith, Kathy Galloway, J. Patrick Waring, John Hunter

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

An association between gastroesophageal reflux (GER) and asthma has been suggested for many decades. Although antireflux therapy (medical and surgical) has been shown to be beneficial in patients with asthma, response to therapy has not been well quantified. The aim of this study was to evaluate long-term outcome in patients with asthma and associated GER undergoing fundoplication. From a database of more than 600 patients with GER treated surgically between 1991 and 1996, 39 patients with asthma as their primary indication for surgery were identified. Asthma symptom scores were determined using the National Asthma Education Program classification, and medication frequency scores were determined preoperatively and at latest follow-up (median follow-up 2.7 years). Comparisons were made using the Wilcoxon rank-sum test. Asthma symptom scores decreased significantly after antireflux surgery. More important, the medication scores for use of systemic corticosteroids decreased significantly postoperatively (2.2 preoperatively vs. 0.7 postoperatively; P = 0.0001). Of the nine patients who required daily oral corticosteroids, seven have discontinued treatment entirely (78%). In patients with asthma associated with GER, symptoms of asthma are improved following fundoplication. Especially important has been the ability to wean patients from systemic corticosteroids postoperatively. Fundoplication should be offered to those patients with GER-associated asthma, especially those who are steroid dependent.

Original languageEnglish (US)
Pages (from-to)477-482
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume3
Issue number5
Publication statusPublished - Sep 1999
Externally publishedYes

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Keywords

  • Antireflux surgery
  • Asthma
  • Gastroesophageal reflux
  • GER
  • Heartburn
  • Reflux
  • Surgery

ASJC Scopus subject areas

  • Surgery

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