It is also known that acute intermittent reflux, while not meeting established criteria for pathologic GER, can precipitate cough and presumably bronchospasm. Although 1 in 5 asthmatics use bronchodilators to treat symptoms which are interpreted as episodes of heartburn, it is not clear if they are treating bronchospasm or esophageal symptoms. Therefore, one of the aims of this trial was to see if we could demonstrate a significant response to acid-suppression therapy in a group of poorly controlled childhood asthmatics using the number of asthma exacerbations as outcome variables. If there is a causal link between GERD and poor asthma control, one would expect that treatment of GERD would improve asthma. The Cochrane review of evidence-based medicine concluded as follows: "In subjects who had both asthma and GER 51, treatment for GER did not produce a consistent improvement in asthma symptom A subgroup of subjects was reported to gain benefit but it appears difficult to predict responders. At present it is not possible to recommend medical treatment of GER as a means to control asthma. The Cochrane database analysis went on to recommend that "…future research is warranted to examine the effects of therapy for GER on asthma control. Additionally, "…a parallel group, randomized placebo controlled trial (RCT) using a proton pump inhibitor for up to 6 months would be appropriate. Such trials should include assessment and standardized reporting of asthma symptoms, quality of life, lung function, symptom and asthma medication diary, and an assessment of the effects of therapy on GER". Moreover, if GERD and asthma are both lifelong conditions, then one might speculate that overall improvement in health outcomes in adulthood can be achieved by successful detection and intervention in the pediatric age group. Therefore, results from a randomized placebo, controlled treatment trial such as the one we completed and have yet to analyze can surely achieve major health benefit for both children and adults suffering from asthma and GERD, and ultimately change clinical practice that will result in a reduction of the overall public health burden incurred by these chronic human conditions.