Is Obesity and Gastro esophageal reflux disease (GERD) Associated with Severe Asthma? � A Study of 181 Cases.

Dr. Alka C Bhat; Dr. Vishnu Sharma.M.; Dr .Harsha D S; Dr Madhu Sudhan. Y; Dr Abhishek Bali

Volume : V, Issue : XI, November - 2016

Is Obesity and Gastro esophageal reflux disease (GERD) Associated with Severe Asthma? � A Study of 181 Cases.

Dr. Alka C Bhat, Dr. Vishnu Sharma. M. , Dr . Harsha D S, Dr Madhu Sudhan. Y, Dr Abhishek Bali

Abstract :

Background: Around 5 – 10% of asthma patients have severe asthma .Severe asthma is considered as a distinct asthma phenotype. Identifying the risk factors, triggers and co morbid conditions associated with severity of asthma will help in further defining this phenotype and subsequent targeted interventions can help in better control of severe asthma. Obesity is not only known to be a risk factor for asthma but is also associated with severe asthma. A significant association has been found between Gastro esophageal reflux disease (GERD) and asthma. Symptomatic GERD is associated with poorly controlled asthma. Aims and objectives: 1. To study association between Obesity and Severe asthma. 2. To study association between GERD and Severe asthma. Materials and Methods: This was a case control study done on 181 onchial asthma patients, attending Respiratory Medicine department of A.J. Institute of Medical Sciences, Mangalore. Detailed history including treatment history and clinical findings of every study subject was obtained and patients were asked peer reviewed, standard asthma related questionnaires. Each patient�s Body Mass Index (BMI) was recorded. Diagnosis of GERD in study subjects was made based on classical symptoms of heartburn and regurgitation. Among the Study population, patients with severe asthma were identified as per GINA and American Thoracic Society recommendations. Data was compiled and statistical analysis was done using Chi-square test and P-value was calculated. Results: Total number of study population was 181, between the age group of 15 to 80 years. 113 (62.4%) were females and 68 (37.6%) were males. 95 patients (52.5%) were having severe asthma. Out of 14 (7.7%) underweight patients 4 (2.2%) had severe asthma. Out of 80 normal weight patients 23(44.2%) had severe asthma. Out of 42 (23.2%) overweight patients, 30 (16.6%) had severe asthma. Out of 45(24.9%) obese patients, 38 (21%) had severe asthma. Severe asthma was more common in overweight and obese patients than in underweight and normal weight patients which were statistically significant. Overweight and obesity was more common in females than in males, which was statistically significant. Total patients with GERD were 89 (49.2%). Out of 89 patients with GERD, 65 (35.9%) had severe asthma and amongst 92 patients without GERD, 30(16.6%) had severe asthma. Severe asthma was more common in patients with GERD which was statistically significant. GERD was more common in overweight and obese patients as compared to normal weight patients. Conclusions: 1. Severe asthma is more common in overweight and obese patients as compared to patients with normal BMI and is more common in females as compared to males. 2. Obesity is associated with higher incidence of GERD and Patients with GERD have higher incidence of severe asthma