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May 30, 1977

Asthma and Gastroesophageal Reflux

JAMA. 1977;237(22):2379. doi:10.1001/jama.1977.03270490019005

To the Editor.—  The article by Dr Mays in The Journal (236:2626,1976) raises the concept that in patients with chronic gastroesophageal (GE) reflux, pulmonary disease may develop as a result. Clinicians have subjectively suspected such an association because patients with documented reflux and coincidental lung disease occasionally will complain of nocturnal cough. There is great potential for acid reflux to occur at night when the patient is supine, and one can speculate that aspiration of refluxed material is more likely during sleep. It is important that we recognize that the apparent relationship between these two entities is more of a "clinical feeling" than having been established by meaningful objective observations, and that although it seems quite likely that there is an important relationship present, we must bear in mind that subjective clinical impressions frequently turn out to be less than factual when objectively tested.It is most disturbing that Mays