The Bidirectional Relationship Between Gastroesophageal Reflux Disease (GERD) and Asthma in Pediatric and Adult Populations: A Systematic Review
Bibliographic record
Abstract
Gastroesophageal reflux disease (GERD) and asthma are prevalent chronic conditions with a well-documented but complex bidirectional relationship. While previous studies have explored their association, a comprehensive synthesis of evidence across pediatric and adult populations is lacking. This systematic review examines the bidirectional relationship between GERD and asthma, focusing on epidemiological, mechanistic, and clinical aspects. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was conducted across PubMed, Web of Science, Scopus, and Science Direct. Eight studies (cohort, case-control, cross-sectional, Mendelian randomization (MR), and bioinformatics analyses) were included after screening 329 records. Data were extracted on study design, population, diagnostic criteria, and key findings. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and Mendelian Randomization Quality (MR-Q) tool. Evidence supports a bidirectional association, with GERD increasing asthma risk (HR 1.62, 95% CI 1.21-2.18) and asthma elevating GERD risk (HR 1.36, 95% CI 1.20-1.54). MR confirmed genetic pleiotropy (OR 1.21 for GERD → asthma; OR 1.06 for asthma → GERD). Mechanistically, microaspiration, vagal reflexes, and shared pathways (e.g., renin-angiotensin system) were implicated. Pediatric studies highlighted GERD's role in poor asthma control, including increased nocturnal symptoms. However, heterogeneity in diagnostic criteria (ICD codes vs. endoscopy) and residual confounding (e.g., obesity) were limitations. GERD and asthma exhibit a bidirectional relationship driven by genetic, neural, and inflammatory mechanisms. Future research should prioritize randomized trials on combined therapies and deeper exploration of the gut-lung axis. Standardized diagnostics and prospective designs are needed to clarify causal pathways.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.030 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.008 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".