Theophylline Gastro-oesophageal reflux [i]

A 19-year-old woman with non­atopic bronchial asthma since childhood and many episodes of airway infection requiring hospitalisation had received continuous theophylline and beta2-stimulant therapy and frequent antibiotics. The patient had experienced regurgitation and vomiting since Infancy without growth impairment, and more recently, epigastric pain and heartburn.

The patient's FEV, was 74% and maximum mid-expiratory flow rate at 25-75% of forced vital capacity was 71% of predicted normal values During 52% of the time of examination gastro-oesophageal reflux (pH below 4) was revealed, the longest reflux (69 min) occurring at night.

Therapy with oral ranitidine 150mg bid and oral domperidone 10mg 15 min before meals and at bedtime was Initiated. Beta2-stimulants and theophylline were continued following an antibiotic course, during which epigastric pain and heartburn continued.

Beta2-stimulants and theophylline were withdrawn and gastro­oesophageal reflux therapy continued, with resolution of reflux symptoms, improvement in asthma and no further pulmonary infection.

In contrast with the findings of some other authors, this case supports a relationship between antiasthmatic drugs and gastro­oesophageal reflux. Conti Nlbah S Famulan C. Pus ton no S. Magazzu G Acta Paedlatnca Scandinavlca 76. 663·664, Jul 1987

14 REACTIONS· 21 November 1987 0157-7271 /87/1121-0014/0$01.00/0 © ADIS Press