الفهرس 
ASTHMAOnly 14 pages are availabe for public view
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Abstract
Background: Gastro-esophageal reflux disease (GERD) is common in adult asthma patient & is a potential trigger of asthma .GERD may be clinically silent and patients may not have classic reflux symptoms. GERD should be suspected when respiratory symptoms tend to worsen with meals, sleep, recumbency& when respiratory symptoms are difficult to control with usual treatment.
Aim of work: The aim of our study is to identify the association gastro-esophageal reflux disease (GERD) in asthmatic patients without reflux symptoms in whom GERD may be trigger for asthma.
Subjects & methods: Our study included 30 asthmatic patients never complaining of GERD symptoms. They were subjected to full history taking, clinical examination, chest x-ray, pulmonary function tests (spirometry pre & post bronchodilators), upper G.I endoscopy& biopsies were obtained from esophagus just above the Z-line & were histologically examined.
Results:-There was a statistically significant association between histopathological examination and asthma classifications. All patients with moderate asthma had chronic esophagitis. Ten patients of 16 severe asthma patients (62.5%) had chronic esophagitis. There was a statistically significant association between nocturnal attacks and histopathology. All patients with attacks ≥ 1/week had chronic esophagitis. There was a statistically significant association between reflux esophagitis, histopathology and asthma classification. All moderate asthma cases had chronic esophagitis. Cases with Grade I reflux had moderate and severe asthma. Mild asthma case had normal histopathology. There was a statistically significant association between competency of cardia, histopathology and asthma classification. All moderate asthma cases had chronic esophagitis and competent cardia. Cases with incompetent cardia and chronic esophagitis were associated with moderate and severe asthma.
Conclusion:- We concluded that the presence of nocturnal attacks in asthmatic patients with clinically silent GERD is associated with histopathological evidence of GERD even in absence of endoscopic features of GERD.