The Relationship Between Asthma and Gastro-Esophageal Reflux

The relationship between asthma and gastro-esophageal reflux has been the subject of many epidemiological studies over the past decades. But the mechanisms underlying this relationship remain obscure, principally for two reasons: first, the lack of studies with sufficient statistical power assessing the physiology of extra-esophageal reflux and the gastro-esophageal junction; and second, the need to understand the development of a vicious circle between the two entities. Comorbidities in asthma patients such as obesity, rhinitis and obstructive sleep apnea probably also intervene in the control of asthma, the link between them being the reflux material. The end result is that asthma and gastro-esophageal reflux are multifactorial entities with many points of contact, meaning that their study requires the participation of at least three specialties—Pulmonology, ENT and Gastroenterology—to thoroughly explore each asthma patient and thus to optimize therapy.