There is inadequate data regarding the effect of new agents, such as omeprazole, a proton pump inhibitor, or the prokinetic agents metoclopramide or cisapride. However, there have been several uncontrolled case series which have reported improvements in asthma symptoms in the majority of patients. Although most patients can be adequately treated for GERD with medical therapy, surgery may be considered for those with severe asthma who fail or who are intolerant of aggressive medical therapy. This effect could be detrimental in patients suffering from reflux-triggered asthma. A vicious cycle of asthma, bronchodilator therapy, and reflux might easily be established.
Theophylline relaxes the lower esophageal sphincter, and stimulates gastric secretion.
The decrease in sphincter pressure attributable to the drug generally last for about 4 hours. Although these drugs decrease lower esophageal sphincter pressure, which often leads to GERD, their role in causing or triggering asthma is not clear. Gastroesophageal reflux disease. Practice parameters for the diagnosis and treatment of asthma. J Allergy Clin Immunol.