What is the relationship between asthma and aspiration?

In chronic obstructive respiratory problems such as asthma and COPD is not often a causative agent, although inhaling smoke snuff seems to be linked to the development of obstruction in COPD and bronchial asthma allergies. However, a time now the mechanism of bronchopulmonary obstruction progress is being questioned, especially when many smokers have stopped smoking and many asthmas adult allergens are not.

An exciting topic emerging from a time now the potential role of aspiration of gastric products that can injure the delicate bronchial structures for toxicity. Aspirations often are silent, ie not present with typical heartburn or regurgitation, a fact that has complicated the investigation of the mechanism. In addition, recent research on the physical laws that determine the output of gastric material into the esophagus and airway show that the same airflow obstruction causes less internal pressure in the esophagus in the stomach, so it facilitates reflux. And what it is more interesting: it could be determined a vicious circle between reflux and obstruction as "motor" maintenance and progress.

In 2016 a paper on bronchoalveolar lavage obtained with bronchoscopy and pepsin determination therein in cases of exacerbation of disease was published.

Pepsin occurs in gastric cells and need not be in Lung if not by displacement there. However, in this work it was verified that the determination of pepsin washing with Pep-Test, a method that analyzes the amount of the enzyme by monoclonal antibodies and that has a recognized sensitivity approaching 100%, showed that pepsin was present in significant in 100% of cases of exacerbation of asthma and COPD amounts.

This and other previous studies in children also with Pep-Test come to give a warning about the cause of relapses of these common diseases.

Refluxed material could amount to air - now called the respiratory reflux - and penetrate bronchus and lung parenchyma, leading to long term inflammatory disorders and scarring. This issue has already been demonstrated in bronchiolitis of transplanted lungs spoiled having filled gastric tissue products.

The corollary is that we should pay more attention to, especially the night silent reflux, since stabilization may hamper the development of these diseases through strong measures against gastroesophageal reflux.

For more information make an appointment with your pulmonologist .