{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:06:19Z","timestamp":1789707979352,"version":"4.0.1"},"reference-count":58,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Jagiellonian University Medical College","award":["K\/ZDS\/000820"],"award-info":[{"award-number":["K\/ZDS\/000820"]}],"id":[{"id":"https:\/\/ror.org\/03bqmcz70","id-type":"ROR","asserted-by":"crossref"}]},{"award":["K\/ZDS\/000820"],"award-info":[{"award-number":["K\/ZDS\/000820"]}],"id":[{"id":"https:\/\/ror.org\/03bqmcz70","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Adv. Respir. Med.","ARM"],"abstract":"<jats:p>Background: Gastroesophageal reflux and exercise-induced bronchoconstriction (EIB) commonly coexist with asthma, but the effect of exercise on reflux remains unclear. We aimed to assess the prevalence of abnormal impedance-detected acid exposure in children with partially controlled or uncontrolled asthma, its association with EIB, and changes in reflux parameters after an exercise challenge test (ECT). Methods: Thirty patients aged 7\u201318 years underwent spirometry, treadmill ECT, and 48 h multichannel intraluminal impedance-pH monitoring. EIB was defined as a \u226510% fall in FEV1, and abnormal acid exposure as impedance-detected acid reflux lasting \u22651.2% of recording time. Results: Abnormal acid exposure was identified in 14\/30 patients (46.7%), whereas EIB occurred in 6\/30 (20.0%), with no significant association between them. The absolute number of reflux episodes was higher after ECT in the count-based analysis (43.0 [35.2\u201369.8] vs. 33.5 [21.2\u201354.5], p = 0.006); however, this finding was not confirmed after normalization to analyzable recording time in a sensitivity analysis. Overweight or obesity was present in 9 patients (30.0%) and correlated positively with acid exposure. BMI-for-age z-score correlated positively with acid exposure (\u03c1 = 0.41, p = 0.025), but these findings did not remain significant after correction for multiple testing. Conclusions: Using the prespecified acid-exposure criterion, abnormal acid exposure was frequently identified in this cohort. No statistically significant association with EIB was demonstrated; however, the small number of EIB events limits definitive conclusions. The higher absolute post-ECT reflux episode count was not confirmed in a rate-based sensitivity analysis, and a causal effect of exercise on reflux cannot be established.<\/jats:p>","DOI":"10.3390\/arm94050066","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:50:27Z","timestamp":1789566627000},"page":"66","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gastroesophageal Reflux Burden Before and After Exercise Challenge in Children with Poorly Controlled Asthma: A 48-Hour MII-pH Study"],"prefix":"10.3390","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7118-0692","authenticated-orcid":false,"given":"Urszula","family":"Jedynak-W\u0105sowicz","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Children\u2019s University Hospital, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]},{"given":"Izabela","family":"Jastrz\u0119bska","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Ma\u0142gorzata","family":"S\u0142adek","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Nutrition, Children\u2019s University Hospital, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"resources","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8046-0527","authenticated-orcid":false,"given":"Liliana","family":"Klim","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Group at Children\u2019s Diseases Clinic, Children\u2019s University Hospital, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"given":"Ewa","family":"Cichocka-Jarosz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s University Hospital, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Grzegorz","family":"Lis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s University Hospital, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e001277","DOI":"10.1136\/bmjpo-2021-001277","article-title":"Diagnosis and Management of Asthma in Children","volume":"6","author":"Martin","year":"2022","journal-title":"BMJ Paediatr. 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