Tohoku J. Exp. Med., 2006, 209(4)

High Prevalence of Gastroesophageal Reflux Disease with Minimal Mucosal Change in Asthmatic Patients

YASUO SHIMIZU, KUNIO DOBASHI,¹ SETSUO KOBAYASHI,² ICHIRO OHKI,² MASAHIKO TOKUSHIMA,² MOTOYASU KUSANO, OSAMU KAWAMURA, YASUYUKI SHIMOYAMA, MITSUYOSHI UTSUGI and MASATOMO MORI

Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan, ¹Gunma University Faculty of Health Science, Gunma, Japan, and ²Maebashi North Hospital, Gunma, Japan

It is known that the prevalence of gastroesophageal reflux disease (GERD) in asthmatic patients is high. Although an endoscopic diagnosis of GERD based on the established Los Angeles (LA) classification requires the detection of erosive mucosal breaks, there are patients with GERD who have prominent erythema of the esophageal membrane without erosive mucosal breaks. Non-erosive mucosal change denotes the minimal change of the discoloring type of reflux esophagitis. This study was undertaken to determine the prevalence of GERD in asthmatic patients using the LA classification with the inclusion of minimal change, compared to the prevalence determined using the established LA classification without minimal change. The presence of GERD in asthmatic patients (n = 78), non-asthmatic disease control patients (n = 56), and healthy subjects (n = 150) was evaluated by endoscopic examination. The frequency of GERD in asthmatic patients based on the LA classification with minimal change was higher (54/78, 69.2%) than in asthmatic patients based on the LA classification without minimal change (37/78, 47.4%) (p < 0.05). The prevalence of GERD in asthmatic patients (69.2%) was higher than that in disease control patients (17/56, 30.4%) and healthy subjects (27/150, 18.0%) based on the LA classification with minimum change. These data indicate that asthmatic patients have a high frequency of GERD. In addition, without the inclusion of minimum change to the diagnosis of GERD, the prevalence of GERD appears to be underestimated in asthmatic patients. Therefore, physicians should carefully observe asthmatic patients with minimal change on endoscopy.

keywords —— asthma; gastroesophageal reflux disease; minimal change; Los Angeles classification; endoscopic examination

© 2006 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2006, 209, 329-336

Correspondence: Yasuo Shimizu, M.D., Ph.D., Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan.

e-mail: yasuos@med.gunma-u.ac.jp