Gambaran klinis dan endoskopi penyakit refluks gastroesofagus (PRGE) pada pasien asma persisten sedang di RS Persahabatan, Jakarta

· Asthma, Journal

Susanto AD, Syafruddin ARL, Sawitri N, Wiyono WH, Yunus F, Prasetyo S. J Respir Indones. 2009;29(1)

Background : Gastroesophageal reflux disease (GERD) close associated with any symptoms and airways disorders including chronic cough and asthma. The prevalence of GERD in asthma
patients still unclear, approximately 34-89%. In many studies showed that approximately 55-82% asthma patients had GERD symptoms. Endoscopy findings from asthma patients showed that
esophagitis prevalence is approximately 27-43%. There is still unknown GERD prevalence and it’s characteristic in asthma patients at Persahabatan Hospital.
Methods and subjects : A cross sectional study have done to know endoscopy finding and GERD characteristic in moderate persistent asthma patients with GERD symptoms. Study from November 2004 and finished Oktober 2005 with total sample were 36 patients. Inclusion criteriae was moderate persistent asthma patients age 15-65 years old, postbronchodilator reversibility test > 12%, bronchial provocations test must be positive and there was one or more typical GERD symptoms include heartburn, regurgitation, atypical chest pain, dysfagia or water brash. GERD symptoms used RDQ (Reflux Disease Questionnaire) by Dent or Chinese GERD Study Group. Correlation between GERD and asthma used Field questionnaire. Esophagitis established by endoscopy examination used Los Angeles 1994 classifications and or histopatologycal examinations of esophagus biopsy. Endoscopy was peformed at subdivision endoscopy department of internal medicine Gatot Subroto-Army Hospital. Histopatology examinations of esophagus biopsy were doing at anatomy patology laboratories at Persahabatan
Hospital-Jakarta, Indonesia.
Result : Regurgitation was a most GERD symptom in moderate persistent asthma patients. Reflux associated respiratory symptoms (RARS) was found at 52,8% patients and use of bronchodilator while reflux episode was found at 50% patients. Among patients who completed the study (n=36), a half of patients (50%) had erosive esophagitis. Erosive esophagitis was divided into grade A with 12 (33.3%) patients, grade B with 4 (11.1%) patients and grade C with
2 (5.6%) patients. Esophageal biopsy was performed in 34 (94.4%) patients and 2 (5.6%) patients were absent. Histopathological examination demonstrated esophagitis in 32 (88.8%) patients and not representative in 2 (5.6%) patients.
Conclusion : Totally 50 % moderate persistent asthma patients with GERD symptoms had erosive esophagitis, 52,8% had reflux associated respiratory symptoms (RARS) and 50% use of
bronchodilator while reflux episode.

Keyword : gastroesophageal reflux disease, erosive esophagitis, moderate persistent asthma

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