salicylates and Gastroesophageal-Reflux

A poor therapeutic response may be explained by incomplete or erroneous diagnostic assessment, by failure to employ optimal drug doses and combinations, or by inadequate attention to the non-pharmacologic aspects of management. Poor compliance and counterproductive patient attitudes may need to be addressed. These problems and the approach to asthma concomitant with other diseases are discussed.

Topics: Asthma; Diabetes Complications; Diagnosis, Differential; Dyspnea, Paroxysmal; Female; Gastroesophageal Reflux; Heart Diseases; Humans; Hyperventilation; Occupational Diseases; Patient Compliance; Physician-Patient Relations; Pregnancy; Pregnancy Complications; Respiratory Tract Diseases; Respiratory Tract Infections; Salicylates; Sleep Wake Disorders; Surgical Procedures, Operative; Sympathomimetics; Theophylline; Thyroid Diseases

We used data from a randomized placebo-controlled clinical trial to examine the relationship between Helicobacter pylori and reflux symptoms in nonulcer dyspepsia patients randomly assigned anti-Helicobacter pylori triple therapy alone, calcium carbonate alone, or in combination with triple therapy, tetracycline, or placebo. We compared risk differences for posttreatment Helicobacter pylori status and increased reflux symptoms from crude, multivariable and stratified multivariable analyses. In crude analyses, 54% of subjects without Helicobacter pylori after-treatment reported an increase in reflux compared to 41% of those with persistent infection (risk difference = 13%; P = 0.07). Only subjects with multifocal atrophic gastritis assigned to calcium carbonate reported an increase in reflux symptoms more frequently when Helicobacter pylori was absent versus when it persisted (risk difference = 52%; P = 0.0001). Therefore, the interaction of calcium carbonate use, chronic multifocal atrophic gastritis, and the absence of Helicobacter pylori may increase reflux symptoms.

Topics: Adult; Amoxicillin; Antacids; Bismuth; Calcium Carbonate; Drug Therapy, Combination; Dyspepsia; Female; Gastric Acidity Determination; Gastritis, Atrophic; Gastroesophageal Reflux; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Organometallic Compounds; Retrospective Studies; Risk Factors; Salicylates; Tetracycline

Topics: Asthma; Bismuth; Female; Gastroesophageal Reflux; Humans; Lupus Erythematosus, Systemic; Middle Aged; Organometallic Compounds; Salicylates; Tongue Diseases