Gastric Asthma
Introduction
Introduction to gastric asthma Gastroesophageal reflux is a manifestation of digestive tract disease. It can cause esophagitis, upper respiratory tract inflammation and other diseases due to the stimulation of acid in the gastric juice. When the gastric juice is inhaled into the airway, it can cause asthma attacks. Animal test results show that even a small amount of gastric juice can stimulate airway receptors and induce asthma. In asthma patients, the incidence of gastroesophageal reflux symptoms is 45% to 60%; the symptoms of stomach burning fever are about 77%. About 55% of the acid sensation, any factor that can cause a decrease in the lower sphincter tension of the esophagus can aggravate reflux. However, about 23% of patients are asymptomatic, also known as "silent reflux." basic knowledge The proportion of illness: 0.003% Susceptible people: no special people Mode of infection: non-infectious Complications: aspiration pneumonia lung abscess
Cause
Gastric asthma cause
Gastric inhalation of the airway can cause asthma attacks, the incidence of gastroesophageal reflux symptoms is 45% to 60%; the symptoms of gastric burning sensation are about 77%, and the acid reflux sensation is about 55%, any which can cause lower tension of the lower esophageal sphincter. Factors can increase the reflux.
The gastric juice component stimulates the afferent nerve of the esophageal vagus nerve, which is transmitted through the vagus nerve of the airway, leading to bronchospasm. The early inhalation of anticholinergic agents in asthma is better than the inhaled sympathomimetic drug, which can explain this point.
The reflux of gastric juice to the airway can cause bronchospasm. This is caused by the stimulation of acidic components in the gastric juice, which causes an increase in airway resistance. In the excitation test, if the acidic liquid flows into the airway, the bronchospasm will increase by more than 2 times. Bronchospasm symptoms can be improved with antacids. Gastric reflux provides increased bronchial reactivity and enhances the sensitivity of asthmatic patients to various triggering factors.
Prevention
Gastric asthma prevention
1. For a small number of patients with obesity caused by gastroesophageal reflux, they should lose weight as appropriate.
2. Eating should try to avoid foods that have too much stomach acid.
3. Anti-reflux surgery should be considered when necessary.
Complication
Gastric asthma complications Complications, aspiration pneumonia, lung abscess
Accompanied by acute aspiration pneumonia, lung abscess.
Symptom
Gastric asthma symptoms common symptoms compound ulcers emotional asthma abscess wheezing nausea cough chest tightness
1. Asthmatic patients have nausea, pantothenic acid, burning pain in the upper abdomen.
2. Gastroesophageal reflux can be accompanied by acute aspiration pneumonia, lung abscess, etc., when the inhalation is large, the pH can be lowered, the alveolar surfactant and normal lung tissue are seriously damaged, and the chemical stimulating reaction increases the capillary permeability of the lung. In severe cases, ARDS can occur.
Examine
Gastric asthma test
Determination of pH: When the amount of gastroesophageal reflux is large, the pH can be lowered. In the challenge test, if the acidic liquid flows into the airway, the bronchospasm will increase by more than 2 times.
Diagnosis
Diagnosis and differentiation of gastric asthma
Coughing, wheezing, chest tightness, wheezing at night, the author is accompanied by nausea, acid reflux, burning pain in the upper abdomen, especially when the body position changes, or the symptoms are aggravated after the application of theophylline, the initial diagnosis is asthma. Gastroesophageal reflux, need to exclude a small number of obese people due to increased abdominal fat, abdominal distension, increased intragastric pressure caused by reflux, suspected inhaled gastric juice patients, feasible dual-channel 24-hour determination of esophagogastric pH to determine the diagnosis.
Diagnostics should be differentiated from cardiogenic asthma, increased COPD nighttime wheezing, and recurrent small pulmonary embolism.
