Research

Associations between respiratory symptoms, lung function and gastro-oesophageal reflux symptoms in a population-based birth cohort

Robert J Hancox¹ , Richie Poulton¹ , D Robin Taylor² , Justina M Greene³ , Christene R McLachlan¹ , Jan O Cowan² , Erin M Flannery¹ , G Peter Herbison⁴ , Malcolm R Sears³ and Nicholas J Talley⁵

¹  Dunedin Multidisciplinary Health and Development Research Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

²  Department of Medical and Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

³  Firestone Institute for Respiratory Health, Department of Medicine, McMaster University, Hamilton, Ontario, Canada

⁴  Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

⁵  Mayo Clinic College of Medicine, Division of Gastroenterology and Hepatology, and Internal Medicine, Mayo Clinic, Rochester Foundation, Rochester, Minnesota, USA

author email corresponding author email

Respiratory Research 2006, 7:142doi:10.1186/1465-9921-7-142

Published:	5 December 2006

Abstract

Background

Several studies have reported an association between asthma and gastro-oesophageal reflux, but it is unclear which condition develops first. The role of obesity in mediating this association is also unclear. We explored the associations between respiratory symptoms, lung function, and gastro-oesophageal reflux symptoms in a birth cohort of approximately 1000 individuals.

Methods

Information on respiratory symptoms, asthma, atopy, lung function and airway responsiveness was obtained at multiple assessments from childhood to adulthood in an unselected birth cohort of 1037 individuals followed to age 26. Symptoms of gastro-oesophageal reflux and irritable bowel syndrome were recorded at age 26.

Results

Heartburn and acid regurgitation symptoms that were at least "moderately bothersome" at age 26 were significantly associated with asthma (odds ratio = 3.2; 95% confidence interval = 1.6–6.4), wheeze (OR = 3.5; 95% CI = 1.7–7.2), and nocturnal cough (OR = 4.3; 95% CI = 2.1–8.7) independently of body mass index. In women reflux symptoms were also associated with airflow obstruction and a bronchodilator response to salbutamol. Persistent wheezing since childhood, persistence of asthma since teenage years, and airway hyperresponsiveness since age 11 were associated with a significantly increased risk of heartburn and acid regurgitation at age 26. There was no association between irritable bowel syndrome and respiratory symptoms.

Conclusion

Reflux symptoms are associated with respiratory symptoms in young adults independently of body mass index. The mechanism of these associations remains unclear.