Gastroesophageal reflux-like symptoms are associated with hyposalivation and oropharyngeal problems in patients with asthma |
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| Authors: | Setsuko Koshiyama Kazuya Tanimura Kayoko Ito Saori Funayama Daiki Hira Yuko Komase Susumu Sato |
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| Affiliation: | 1. Kyoto Pharmaceutical Association, 563 Bairin-cho, Higashioji Gojo Agaru, Higashiyama-ku, Kyoto, 605-0863, Japan;2. Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan;3. Oral Rehabilitation, Niigata University Medical and Dental Hospital, 754 Asahimachi-dori Ichibancho, Chuo-ku, Niigata, 951-8520, Japan;4. College of Pharmaceutical Sciences, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan;5. Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama-City Seibu Hospital, 1197-1 Yasashi-cho, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan;6. NPO Association of Inhalation Therapist, 1197-1 Yasashi-cho, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan;1. Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan;2. Department of Radiology, Tohoku University Graduate School of Medicine, 2-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan;3. Department of Pathology, Tohoku University Graduate School of Medicine, 2-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan;1. Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan;2. Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose-shi, Tokyo, 204-8522, Japan;3. Department of Rehabilitation, Kanamecho Hospital, 1-11-13 Kanamecho, Toshima-ku, Tokyo, 171-0043, Japan;1. Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan;2. Department of Respiratory Medicine, Ogaki Municipal Hospital, Ogaki, Japan |
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| Abstract: | BackgroundPrevious studies have suggested a significant relationship between hyposalivation and inhalation therapy-induced oropharyngeal problems. However, salivary secretion tests are not widely performed in daily clinical practice. In fact, xerostomia, the complaint of dry mouth, may not indicate hyposalivation. Therefore, we determined the clinical factors associated with hyposalivation in patients with asthma.MethodsThis study is a post-hoc analysis of our previous studies. Adult patients with asthma on maintenance inhalation therapy were enrolled. The participants completed questionnaires on oropharyngeal symptoms and underwent a salivary secretion test. Symptom severity was evaluated using a numerical rating scale (NRS), and salivary secretion was measured using the modified cotton roll method. Using logistic regression analysis, we identified the clinical factors associated with hyposalivation.ResultsIn total, 531 patients completed the questionnaire (43.8 ± 16.9 years and male/female = 171/360), and 234 patients successfully performed a salivary secretion test, of which 126 (53.8%) were diagnosed with hyposalivation (<0.25 g/min). The patients with hyposalivation were significantly older (p < 0.0001) and had severe xerostomia and/or gastroesophageal reflux-like symptoms (GERLS) (p < 0.0001). Many of these patients had also used inhaled long-acting beta agonists (p = 0.012) and high-dose inhaled corticosteroids (p = 0.024). Multivariate analysis revealed that advanced age (odds ratio [OR] 1.05, p < 0.0001), severe xerostomia (OR 1.02, p = 0.0006) and severe GERLS (OR 1.02, p = 0.001) were independently and significantly associated with hyposalivation.ConclusionsAge, xerostomia, and GERLS were significantly related to hyposalivation in patients with asthma. To identify oropharyngeal problems in these patients, a careful assessment of the suspected symptoms of gastroesophageal reflux may be useful. |
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| Keywords: | Hyposalivation Oropharyngeal problems Gastroesophageal reflux disease Inhalation therapy Asthma DPI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" Dry powder inhaler FP" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" Fluticasone propionate GERD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" Gastroesophageal reflux disease GERLS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" Gastroesophageal reflux-like symptoms ICS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0080" }," $$" :[{" #name" :" text" ," _" :" Inhaled corticosteroid LTRA" },{" #name" :" keyword" ," $" :{" id" :" kwrd0090" }," $$" :[{" #name" :" text" ," _" :" Leukotriene receptor antagonist NRS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0100" }," $$" :[{" #name" :" text" ," _" :" Numerical rating scale SD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0110" }," $$" :[{" #name" :" text" ," _" :" Standard deviation GINA" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040J" }," $$" :[{" #name" :" text" ," _" :" Global Initiative for Asthma LABA" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040D" }," $$" :[{" #name" :" text" ," _" :" long-acting beta agonists BUD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040B" }," $$" :[{" #name" :" text" ," _" :" budesonide MF" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040C" }," $$" :[{" #name" :" text" ," _" :" mometasone furoate BDP" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040A" }," $$" :[{" #name" :" text" ," _" :" beclomethasone dipropionate HFA" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040E" }," $$" :[{" #name" :" text" ," _" :" hydrofluoroalkane CIC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040F" }," $$" :[{" #name" :" text" ," _" :" ciclesonide OR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040G" }," $$" :[{" #name" :" text" ," _" :" odds ratio CI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040H" }," $$" :[{" #name" :" text" ," _" :" confidence interval |
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