Proximal Reflux as a Cause of Adult-Onset Asthma

Abstract

Gastroesophageal reflux disease (GERD) is the most common esophageal disorder in Western countries.¹ Although patients with GERD typically present with heartburn and regurgitation, many patients also report atypical (extraesophageal) symptoms, such as globus sensation, hoarseness, and throat clearing, and respiratory symptoms, such as cough and shortness of breath. Accumulating evidence suggests a strong association between GERD and pulmonary diseases, including adult-onset asthma (AOA). The prevalence of GERD in patients with asthma has been reported to range from 30% to 90%.^2-5 On this basis, guidelines⁶ for the treatment of asthma issued from the National Institutes of Health recommended that evaluation for the presence of GERD be considered in patients with poorly controlled asthma.