Does Ongoing Acid Reflux (GERD) Lead to Asthma?

When one thing leads to another, the end result can be for the better – like a chance encounter that brings about a career opportunity or a simple discovery that creates a thriving business. However, with ongoing acid reflux/GERD (Gastroesophageal Reflux Disease), the ripple effect is less desirable. The leaking stomach acid that causes symptoms in your upper digestive tract can lead to problems in your lungs and eventually leave you short of breath.

While the exact cause and effect is yet to be determined, the link between acid reflux and adult onset asthma is clear – an estimated 75% of asthma sufferers are diagnosed with ongoing acid reflux or GERD. That’s why in allergy clinics, patients that seek help for their constricted airways are often referred to their primary care doctor or a gastroenterologist. As the reflux improves, the wheezing and shortness of breath, in many cases, resolves.

How do you know if your acid reflux is causing asthma?

If you’re experiencing symptoms like shortness of breath, a whistle or hissing when you inhale or exhale, coughing – particularly at night, and tightening or pain in your chest, you may have asthma and should see your doctor. Symptoms can vary from person to person and episodes can range from mild to severe. While the latter needs immediate medical attention, mild symptoms also need the proper care to keep asthma in check.

Here are some signs that GERD may be causing asthma:

  • asthma develops as an adult
  • asthma symptoms intensify following a meal, exercising, or lying down
  • coughing, wheezing and chest pain worsen at night
  • there is no response to standard asthma treatment

Several theories explain the link between GERD and adult onset asthma. One suggests that acid irritates the lungs and airways, causing sensitivities to pollutants and cold air. Another suggests that acid in the esophagus prompts a nerve reflex causing the airways to constrict.

According to Dr. Blair Jobe, one of the nation’s preeminent esophageal disease specialists, stomach acid that gets washed back into the esophagus forms a mist and ends up going down the windpipe and into the lungs. In his clinic, it’s assumed that reflux is the cause of adult onset asthma unless proven otherwise. 

The good news is that when acid reflux is addressed, asthma symptoms can get better. Dr. Jobe co-authored a recent study that assessed the patterns and proximity of reflux episodes in patients with adult onset asthma. The study found that 90% of patients who resolved their acid reflux experienced improvement in their asthma symptoms. (The patients underwent laparoscopic surgery to treat their reflux.) 

Given the strong connection, it’s important for every reflux sufferer to know the signs of asthma. For some, understanding the link between the two diseases lends a higher priority to practicing effective daily habits. Avoiding trigger foods, eating smaller meals and sleeping with MedCline can help keep stomach acid where it belongs. Then you can breathe easier knowing you’re doing your part to prevent reflux and the onset of asthma.

For more information on lifestyle changes that can have a real impact on acid reflux, see the posting “Refluxology: Understanding Acid Reflux and Finding Relief”.

References:

1. Rodriguez LG, Ruigómez A, Martin-Merino E, Johansson S, Wallander MA. Relationship between gastroesophageal reflux disease and COPD in UK primary care. Chest. 2008;1223-1230. 

2. Cleveland Clinic. “Diseases and Conditions: GERD and Asthma”. my.clevelandclinic.org/disorders /gastroesophageal_reflux_gerd/hic_gerd_and_asthma.aspx. February, 2008.

3. Yoshihiro Komatsu, MD; Toshitaka Hoppo, MD, PhD; Blair A. Jobe, MD. “Proximal Reflux as a Cause of Adult-Onset Asthma. The Case for Hypopharyngeal Impedance Testing to Improve the Sensitivity of Diagnosis.” JAMA Surg. 2013;148(1):50-58. doi:10.1001/jamasurgery.2013.404. January, 2013. 

4. Laurent, Dan. “Study by West Penn Allegheny Surgeons Points to Gastroesophageal Reflux Disease (GERD) as Cause of Adult-Onset Asthma” http://healthandmedicinefoundation.org/study-by-w... points-to-gastroesophageal-reflux-disease-gerd-as-cause-of-adult-onset-asthma.htm. January, 2013.