Summary
The aim of the study was to determine whether gastro-oesophageal (GO)-reflux was increased by normal maintenance doses of theophylline, and if so, whether this was detrimental to lung function in asthmatic patients with symptoms of reflux. In 25 patients with moderate or severe bronchial asthma and a history of respiratory symptoms aggravated by reflux, two consecutive oesophageal 24-h pH recordings were made, one with and the other without their ordinary dose of slow release theophylline.
The theophylline treatment caused a significant increase in total reflux time and reflux symptoms but did not worsen the asthma. Patients with subtherapeutic serum levels showed significant improvement in lung function and those with therapeutic serum levels did not.
It is concluded that theophylline, in view of its potential to exacerbate GO-reflux, should be used with caution as maintenance therapy in asthmatic patients with GO-reflux.
Similar content being viewed by others
References
Foster LJ, Trudeau WL, Goldman AL (1979) Bronchodilator effects on gastric acid secretion. J Am Med Assoc 241: 2613–2615
Berquist WE, Rachelefsky GS, Kadden M, Siegel SC, Katz RM, Mickey MR, Ament ME (1981) Effect of theophylline on gastroesophageal reflux in normal adults. J Allergy Clin Immunol 67: 407–411
Stein MR, Towner TG, Weber RW, Mansfield LE, Jacobson KW, McDonnell JT, Nelson HS (1980) The effect of theophylline on the lower esophageal sphincter pressure. Ann Allergy 45: 238–241
Johannesson N, Andersson KE, Joelsson B, Persson CG (1985) Relaxation of lower esophageal sphincter and stimulation of gastric secretion and diuresis by antiasthmatic xanthines. Role of adenosine antagonism. Am Rev Respir Dis 131: 26–30
Overholt RH, Ashraf MM (1966) Esophageal reflux as trigger in asthma. NY J Med 66: 3030–3032
Mansfield LE, Stein MR (1978) Gastroesophageal reflux and asthma: A possible reflex mechanism. Ann Allergy 10: 224–226
Spaulding HS, Mansfield LE, Stein MR, Sellner JC, Gremillion DE (1982) Further investigation of the association between gastroesophageal reflux and bronchoconstriction. J Allergy Clin Immunol 69: 516–521
Kjellén G, Tibbling L, Wranne B (1981) Bronchial obstruction after oesophageal acid perfusion in asthmatics. Clin Physiol 1: 285–292
Goodall RJR, Earis JE, Cooper DN, Bernstein A, Temple JG (1981) Relationship between asthma and gastrooesophageal reflux. Thorax 36: 116–121
Mays EE (1976) Intrinsic astma in adults. Association with gastroesophageal reflux. J Am Med Assoc 236: 2626–2628
Winterleitner H, Eibl M, Jarisch R, Mazoch R, Kummer F, Wurnig P (1979) Bronchial asthma and gastroesophageal reflux in childhood. Kinderchir Geb 27: 216–226
Shapiro GG, Christie DL (1979) Gastroesophageal reflux in steroid-dependent asthmatic youths. Pediatrics 63: 207–212
Martin ME, Grunstein MM, Larsen GL (1982) The relationship of gastroesophageal reflux to nocturnal wheezing in children with asthma. Ann Allergy 49: 318–322
American Thoracic Society (1962) Definitions and classification of chronic bronchitis, asthma and pulmonary emphysema. Am Rev Respir Dis 85: 762–768
Johansson K-E, Tibbling L (1985) Evaluation of the 24-hr pH-test at two different levels of the oesophagus. In: DeMeester TR, Skinner DB (eds) Esophageal disorders. Pathophysiology and therapy. Raven Press, New York, pp 579–582
Johansson K-E, Boeryd B, Fransson S-G, Tibbling L (1986) Oesophageal reflux tests, manometry, endoscopy, biopsy and radiology in healthy subjects. Scand J Gastroenterol 21: 399–406
DeMeester TR, Johnson LF, Joseph GJ, Toscano M, Hall A, Skinner D (1976) Patterns of gastroesophageal reflux in health and disease. Ann Surg 184: 459–470
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ekström, T., Tibbling, L. Influence of theophylline on gastro-oesophageal reflux and asthma. Eur J Clin Pharmacol 35, 353–356 (1988). https://doi.org/10.1007/BF00561363
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00561363