Asma bronchiale e reflusso gastroesofageo

Asthma is an inflammatory disease of the airways characterized by increased airway reactivity with airflow obstruction. It is exacerbated by multiple triggers and one common, often overlooked trigger, is gastroesophageal reflux (GER). The prevalence of GER in asthma is estimated at between 34% and 80%. The relationship between the occurrence of gastroesophageal disorders and of changes in respiratory function has been known for long time even though the mechanism by which intra-esophageal add regurgitation from stomach can produce bronchoconstrinction, heightened bronchial hyperresponsiveness and other asthma symptoms is still debated. Some patients may not have reflux symptoms, leaving the clinician unaware that GER reflux may be a pathogenetic factor in asthma, but patients with refractory asthma generally should be evaluated for gastroesophageal reflux. In this review we discussed the epidemiology, the pahogenetic hypotheses, the clinical, biological and diagnostic indicators and the therapeutic strategies of GER-related asthma.