الفهرس 
BRONCHIAL ASTHMAOnly 14 pages are availabe for public view
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Abstract
Inhaled corticosteroids are recommended as first line antiinflammatory
therapy for the treatment of asthma. Inhaled
corticosteroids have been used for the treatment of asthma in
children for more than 20 years. During this time, a substantial
number of studies have been performed evaluating the safety and
efficacy of this therapy. Generally, the results have been
reassuring. Inhaled corticosteroids have a marked effect on both
the immediate and the long-term aims of asthma therapy. Inhaled
glucocorticosteroids are the most effective controller therapy, and
are therefore the recommended treatment for asthma for children
of all ages.
In this cross-sectional case control study we evaluated the
effects of inhaled corticosteroids (ICS) on gastrointestinal tract by
lactulose breath hydrogen test as indicator of small bowel
bacterial overgrowth (SBBO).
It included 60 children as patient group with persistent
bronchial asthma with its different subgroups treated with inhaled
corticosteroids (ICS) for at least 3 months. They were 31 males
and 29 females with mean age (7.13+ 3.72) years and were chosen
randomly from those patients attending the Allergy &
Immunology unit and assessed in Gastroenterology unit, Pediatric
Summary and Conclusion
94
Hospital, Ain Shams University. And compared to 20 healthy age
and sex matched cohort serving as a control group.
All patients included were subjected to:
Full history taking.
Through clinical examination.
Lactulose breath hydrogen test.
Monilial stomatits was significantly more frequent among
patients (33.3%) compared to controls (5%) with p value (0.013).
Four cases (6.7%) were positive for small bowel bacterial
overgrowth (SBBO) among patients compared to none in controls,
however the difference was not statistically significant. The
majority of the controls had normal OCTT (90%), while 13.3%
only of patients had normal OCTT, but no significant correlation
was detected between asthma severity and SBBO and there was
significant correlation between asthma severity and OCCT. All
patients with severe persistent asthma had shortened OCTT.
All GIT symptoms and sings had no correlation with SBBO
or OCTT with exception of both vomiting and monilial stomatitis
that show significant correlation with OCTT.
Summary and Conclusion
95
No significant correlation was detected between the results
of stool analysis and (SBBO or OCTT).
Both daily and cumulative doses of ICS had no impact on
the presence of SBBO in patients group or OCTT.
We can conclude that monilial stomatitis is more frequent
in asthmatic children on ICS, so they need vigorous oral hygiene
instruction.
Also, OCTT is shortened in severe persistent form of
bronchial asthma. However, SBBO was not significantly different
between patients and controls. This may reflect the safety of ICS
on the intestinal bacterial colonization point.