[Gastroesophageal reflux and bronchial asthma].

Gastroesophageal reflux was established in 12 out of 38 patients with infectious allergic bronchial asthma out of exacerbation. According to intraesophageal pH-metry, it turned out appreciable in half of the cases. Prospective observations conducted for up to 8 years made it possible to recognize bronchial asthma in 9 out of 63 patients having initial reflux without any bronchopulmonary alterations. Diminution of the tone of the inferior sphincter of the esophagus proved by electromanometry should be regarded as the leading mechanism by which gastroesophageal reflux developed in bronchial asthma patients. In patients having gastroesophageal reflux without bronchopulmonary pathology, the tone of the upper sphincter of the esophagus was normal or elevated whereas in bronchial asthma patients with reflux, the tone of the superesophageal sphincter was naturally lowered, causing microaspiration into the bronchi of the gastric contents flown to the esophagus. It is desirable that metoclopramide (cerucal) which increases the initially reduced tone of the esophageal sphincters may be included into a complex of therapeutic measures elaborated for patients with associated bronchial asthma and gastroesophageal reflux.