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May 1987

Treatment of Gastroesophageal Reflux-Induced Asthma: Steroids, ß2-Stimulants, and H2-Blockers

Arch Intern Med. 1987;147(5):997. doi:10.1001/archinte.1987.00370050189038

To the Editor.  —I am very interested in the report by Harper et al,1 published in the January 1987 issue of the Archives, concerning treatment for gastroesophageal reflux-induced asthma. I also agree with their conclusion that an antireflux treatment may improve asthmatic and/or reflux symptoms in asthmatic patients associated with gastroesophageal reflux-triggered bronchoconstriction. I recently encountered a 61-year-old man in Japan with nonallergic asthma and a sliding hiatal hernia. The patient was admitted to my division because of a wheezing attack with dyspnea, abdominal fullness during asthma attack, inveterate hiccups, and sour and acid regurgitation. An upper gastrointestinal tract roentgenogram study had revealed a sliding hiatal hernia when the patient was admitted to my division complaining of wheezing attack six years before. In spite of treatment with 500 mg of theophylline, 150 μg of procaterol (β2-stimulant), and 10 mg of prednisolone for about one month, the wheezing