Digestive Diseases and Sciences

, Volume 39, Issue 10, pp 2127–2133 | Cite as

Does omeprazole (Prilosec) improve respiratory function in asthmatics with gastroesophageal reflux?

A double-blind, placebo-controlled crossover study
  • John H. Meier
  • Peter R. McNally
  • Madhukar Punja
  • Stephen R. Freeman
  • Robert H. Sudduth
  • Nancy Stocker
  • Michael Perry
  • Harry S. Spaulding
Esophageal, Gastric, And Duodenal Disorders


Gastroesophageal reflux (GER) is common among patients with asthma, and it has been speculated that high GER may exacerbate asthma in some. This study was designed to determine if suppression of acid reflux in patients with asthma would improve pulmonary function. A double-blind, placebo-controlled crossover study design was used to determine the effect of GER suppression with omeprazole (20 mg twice daily) on pulmonary function among asthmatic patients with esophagitis. Four of 15 (27%) asthma patients with GER were shown to have a≥20% net improvement in pulmonary function (FEV1) after treatment for six weeks with omeprazole. These results indicate that some patients with asthma and GER will have improved pulmonary function when acid GER is treated with omeprazole.

Key Words

asthma gastroesophageal reflux esophagitis omeprazole 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Sontag SJ, O'Connell S, Khandelwal S, Miller T, Nemchausky B, Schnell TG, Serlovsky R: Most asthmatics have gastroesophageal reflux with or without bronchodilator therapy. Gastroenterology 99:613–620, 1990PubMedGoogle Scholar
  2. 2.
    Osler W: Textbook of Medicine. Philadelphia, Lea & Febiger, 1882, p 448Google Scholar
  3. 3.
    Mendelssohn CL: The aspiration of stomach contents into the lungs during obstretic anesthesia. Am J Obstet Gynecol 52:191, 1946Google Scholar
  4. 4.
    Crausaz FM, Favez G: Aspiration of solid food particles into lungs of patients with gastroesophageal reflux and chronic bronchial disease. Chest 93:376–378, 1988PubMedGoogle Scholar
  5. 5.
    Bray GW: Recent advances in the treatment of asthma and hayfever. Practitioner. 34:368–375, 1934Google Scholar
  6. 6.
    Mansfield LE, Stein MR: Gastroesophageal reflux and asthma: A possible reflex mechanism. Ann Allergy 41:224–226, 1978PubMedGoogle Scholar
  7. 7.
    Tuchman DN, Bolye JT, Pack AI, Schwartz J, Kokonos M, Spitzer AR, Cohen S: Comparison of airway response following tracheal or esophageal acidification in the cat. Gastroenterology 87:872–881, 1984PubMedGoogle Scholar
  8. 8.
    Spaulding HS, Mansfield LE, Stein MR, Sellner JC, Gremillion DE: J Allergy Clin Immunol 69:516–521, 1982PubMedGoogle Scholar
  9. 9.
    Harper PC, Bergner A, Kaye MD: Antireflux treatment for asthma. Improvement in patients with associated gastroesophageal reflux. Arch Intern Med 147:56–60, 1987PubMedGoogle Scholar
  10. 10.
    Goodall RJ, Earis JE, Cooper DN, Bernstein A, Temple JG: Relationship between asthma and gastroesophageal reflux. Thorax 36:116–121, 1981PubMedGoogle Scholar
  11. 11.
    Ekstrom T, Lindgren BR, Tibbling L: Effects of ranitidine on patients with asthma and a history of gastro-oesophageal reflux: A double blind cross over study. Thorax 44:19–23, 1989PubMedGoogle Scholar
  12. 12.
    Nagel RA, Brown P, Perks WH, Wilson RSE, Kerr GD: Ambulatory pH monitoring of gastro-oesophageal reflux in “morning dipper” asthmatics. Br Med J 297:1371–1373, 1988Google Scholar
  13. 13.
    Sontag SJ: The medical management of reflux esophagitis, role of antacids and acid inhibition. Gastroenterol Clin North Am 19:683, 1990PubMedGoogle Scholar
  14. 14.
    Maton PN: Omeprazole: Drug therapy. N Engl J Med 324:965–975, 1991PubMedGoogle Scholar
  15. 15.
    Sontag S, Hirschowitz BI, Holt S, Robinson MG, Behar J, Berenson MM, McCullough A, Ippoliti AF, Richter JE, Ahtaridis G, McCallum RW, Pambianco DJ, Vlachcevic RZ, Johnson DA, Collen MJ, Lyon DT, Humphries TJ, Cagliola A, Bertman RS: Two doses of omeprazole versus placebo in symptomatic erosive esophagitis: The US multicenter study. Gastroenterology 102:109–118, 1992PubMedGoogle Scholar
  16. 16.
    Collen MJ, Strong RM: Comparison of omeprazole and ranitidine in treatment of refractory gastroesophageal reflux disease in patients gastric acid hypersecretion. Dig Dis Sci 1992:877–903, 1992Google Scholar
  17. 17.
    Havelund T, Laursen LS, Skoubo-Kristensen E, Andersen BN, Pedersen SA, Jensen KB, Fenger C, Hanberg-Sorensen F, Lauritsen K: Omeprazole versus ranitidine in reflux esophagitis: Double blind comparative trial. Br Med J 296:89–92, 1988Google Scholar
  18. 18.
    Bell NJV, Hunt RH: Role of gastric acid suppression in the treatment of gastroesophageal reflux disease. Gut 33:118–124, 1992PubMedGoogle Scholar
  19. 19.
    American Thoracic Society: Definitions and classification of chronic bronchitis, asthma and pulmonary emphysema. Am Rev Respir Dis 85:762–768, 1962Google Scholar
  20. 20.
    Richter JE, Wu NC, Johns DN, Blackwell JN, Nelson JL, Castell JA, Castell DO: Esophageal manometry in 95 healthy adult volunteers. Dig Dis Sci 32:583, 1987PubMedGoogle Scholar
  21. 21.
    Collen MJ, Lewis JH, Benjamin SB: Gastric acid hypersecretion in refractory gastroesophageal reflux disease. Gastroenterology 98:654–661, 1990PubMedGoogle Scholar
  22. 22.
    Shaker R, Dodds WJ, Ren J, Hogan WJ, Arndorfer RC: Esophageal closure reflex: A mechanism of airway protection. Gastroenterology 163:401–406, 1992Google Scholar
  23. 23.
    DeMeester TR, Bonavina L, Iascone C, Courtney JV, Skinner DB: Chronic respiratory symptoms and occult gastroesophageal reflux: A prospective clinical trial and results of surgical therapy. Ann Surg 211:337–345, 1990PubMedGoogle Scholar
  24. 24.
    Koufman JA: The otolaryngoscopic manifestations of gastroesophageal reflux disease (GERD): A clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 101:1–78, 1991Google Scholar
  25. 25.
    Katz PO: Ambulatory esophageal and hypopharyngeal monitoring in patients with hoarseness. Am J Gastroenterol 85:38–40, 1990PubMedGoogle Scholar
  26. 26.
    McNally PR, Maydonovitch CL, Prosek RA, Collette RP, Wong RKH: Evaluation of Gastroesophageal reflux as a cause of idiopathic hoarseness. Dig Dis Sci 34:1900–1904, 1989PubMedGoogle Scholar
  27. 27.
    Richter JE, Castell DO: Gastroesophageal reflux: pathogenesis, diagnosis, and therapy. Ann Intern Med 97:93–103, 1982PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1994

Authors and Affiliations

  • John H. Meier
    • 1
  • Peter R. McNally
    • 1
  • Madhukar Punja
    • 1
  • Stephen R. Freeman
    • 1
  • Robert H. Sudduth
    • 1
  • Nancy Stocker
    • 1
  • Michael Perry
    • 1
  • Harry S. Spaulding
    • 1
  1. 1.From the Department of Medicine and Services of Gastroenterology, Allergy/Immunology, Pharmacology, and PulmonaryFitzsimons Army Medical CenterAurora

Personalised recommendations