![]() | Only 14 pages are availabe for public view |
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. |