Background: The asthmatic children who do not respond favorably to the specifically anti-allergic treatment, and also begin their breathlessness crisis preferably at night, are suspicious of suffering gastric-esophagus reflux that stimulate bronchial spasm crisis by means of an aspiration mechanism, or more frequently, by means of a reflective mechanism through the vagal via.
Objectives: To know probable physiopathologic mechanism of gastric-esophagus reflux that exacerbates asthmatic crisis. To know digestive symptoms associated to respiratory process. To evaluate clinic evolution of children after antireflux treatment.
Material and methods: There were chosen 50 moderate-severe persistent asthmatic patients with non favorable evolution and gastric-esophagus reflux. The diagnosis was settled by means of radiological study, with barium contrast in esophagus, stomach and duodenum, and esophagus-pulmonary gammagraphy with technetium 99 (99mTc). Besides, a searching of bronchial aspiration signs with the isotopic exploration was carried out.
Results: It was demonstrated that 38% of all cases had bronchial microaspirations and 30% did not have digestive symptoms associated to the respiratory process. Patients were subjected to an antireflux treatment and 78% of them considerably improved their asthmatic crisis after the treatment.
Conclusions: 38% of the cases showed bronchial microaspirations in pulmonary gammagraphy. The more probable physiopathologic mechanism was vagal via, because 62% of the patients did not have bronchial aspiration signs. There were no digestive symptoms (silent reflux) in 30% of the children. Asthmatic crisis evolved favorably in 78% of the cases after antireflux treatment.