What Should I Do if I Have Asthma And Gastroesophageal Reflux Disease (GERD)

What Should I Do if I Have Asthma And Gastroesophageal Reflux Disease (GERD)


People with asthma are nearly twice as likely as those without asthma to suffer from the chronic form of acid reflux known as gastroesophageal reflux disease (GERD). In fact, research has shown that more than 75 percent of adults with asthma also have GERD.

Does GERD cause asthma?


Although studies have shown a relationship between asthma and GERD, the exact relationship is uncertain. GERD may worsen asthma symptoms, but asthma and some asthma medications may in turn worsen GERD symptoms. However, treating GERD often helps to also relieve asthma symptoms, further suggesting a relationship between the two conditions.

Doctors most often look at GERD as the cause of asthma when:

  • Asthma begins in adulthood
  • Asthma symptoms get worse after a meal, after exercise, at night or after lying down
  • Asthma doesn't respond to the standard asthma treatments.

Symptoms


The predominant symptom of GERD in adults is frequent heartburn (acid indigestion). However, in some adults and most children, GERD will occur without heartburn. Instead, symptoms may appear in the form of asthmatic symptoms such as a chronic dry cough or difficulty swallowing. Some clues that your asthma may be connected to GERD include:

  • asthma symptoms that begin in adulthood
  • asthma symptoms that worsen following a large meal or exercise
  • asthma symptoms that occur while drinking alcoholic beverages
  • asthma symptoms that happen at night or while lying down
  • asthma medications are less effective than usual
It can be difficult to identify symptoms of GERD in children, especially if they’re very young. Infants less than one year old will often experience symptoms of acid reflux—such as frequent spitting up or vomiting—with no ill effects. However, in older toddlers and children, GERD may present as:

  • nausea
  • heartburn
  • repeated regurgitation
  • symptoms of asthma, such as coughing, laryngitis, and wheezing
Infants and young children may:

  • become irritable
  • arch their backs (usually during or immediately following feedings)
  • refuse to eat
  • experience poor growth

How can GERD affect my asthma?


As previously mentioned, the exact link between the two conditions is uncertain. However, there are a few possibilities as to why GERD and asthma may coincide. One possibility is that the acid flow causes injury to the lining of the throat, airways and lungs, making inhalation difficult and often causing a persistent cough.

Another possibility for patients with GERD is that when acid enters the esophagus, a nerve reflex is triggered, causing the airways to narrow in order to prevent the acid from entering. This will cause a shortness of breath.

What should I do if I have asthma and GERD?


If you have both asthma and GERD, it is important that you consistently take any asthma medications your doctor has prescribed to you, as well as controlling your exposure to asthma triggers as much as possible.

Fortunately, many of the symptoms of GERD can be treated and/or prevented by taking steps to control or adjust personal behavior. Some of these steps include:

  • Raise the head of your bed by six inches to allow gravity to help keep the stomach's contents in the stomach. (Do not use piles of pillows because this puts your body into a bent position that actually aggravates the condition by increasing pressure on the abdomen.)
  • Eat meals at least three to four hours before lying down, and avoid bedtime snacks.
  • Eat smaller meals with moderate portions of food.
  • Maintain a healthy weight to eliminate unnecessary intra-abdominal pressure caused by extra pounds.
  • Limit consumption of fatty foods, chocolate, peppermint, coffee, tea, colas, and alcohol - all of which relax the lower esophageal sphincter - and tomatoes and citrus fruits or juices, which contribute additional acid that can irritate the esophagus.
  • Give up smoking, which also relaxes the lower esophageal sphincter.
  • Wear loose belts and clothing.
Aside from these steps, over-the-counter antacids can often relieve GERD symptoms. However, if after one to two weeks these medications do not help with your symptoms, your doctor may need to prescribe medications that block or limit the amount of stomach acid your body produces. Under rare circumstances, GERD may only be treatable through surgery.

Lifestyle Changes


Due to the ineffectiveness of certain medications when treating acid reflux and asthma together, the best treatment may be to control symptoms of GERD with lifestyle changes, such as:

  • losing excess weight
  • quitting smoking
  • avoiding foods that contribute to acid reflux, including alcoholic or caffeinated beverages, chocolate, citrus fruits, fried and fatty foods, garlic, mint such as peppermint and spearmint, onions, spicy foods, and tomato-based foods such as pizza, salsa, and spaghetti sauce
  • eating smaller meals more often
  • eating meals at least three to four hours before bed
  • avoiding bedtime snacks
  • avoiding asthma triggers as much as possible
Other steps that may help to control GERD include:

  • raising the head of the bed six to eight inches by placing blocks underneath bedposts (extra pillows are ineffective)
  • wearing loose clothing and belts
  • taking over-the-counter antacids