Shortness of Breath

Difficulty breathing is one of the more frightening symptoms of acid reflux or the chronic form of the condition, gastroesophageal reflux disease (GERD). Research published in the Journal of Clinical Gastroenterology notes that GERD may be associated with breathing difficulties such as bronchoaspiration, which can sometimes lead to life-threatening respiratory complications.

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Shortness of breath, also called dyspnea, occurs with GERD because stomach acid that creeps into the esophagus can cause it to narrow. According to the American Speech-Language-Hearing Association (ASHA), when gastric acid reaches the vocal folds, airways, and lungs, it can cause a swelling of the passages which can lead to atypical asthma reactions. Such airway damage can affect breathing by causing coughing or wheezing and making swallowing solid foods more difficult.

GERD and Asthma

While shortness of breath can occur in GERD alone, it often occurs in conjunction with asthma, as the two conditions are often linked. In fact, the Cleveland Clinic estimates that:

  • more than three quarters of asthma patients also suffer from GERD
  • people with asthma are twice as likely as those without asthma to have GERD
  • those with a severe, chronic form of asthma that’s resistant to treatment are most likely to also have GERD

Although research has shown a relationship between asthma and GERD, the exact link between the two conditions is uncertain. One possibility is that acid flow causes injury to the throat lining, airways, and lungs, making inhalation difficult. Another reason may be that when acid enters the esophagus, it triggers a nerve reflex that causes airways to constrict to keep acid out, which leads to shortness of breath.

Just as GERD may worsen asthma symptoms and vice versa, treating GERD often helps improve asthma symptoms like shortness of breath. Doctors are more likely to attribute GERD to be the cause of asthma when asthma:

  • starts in adulthood
  • symptoms worsen after eating, exercise, lying down, or at night
  • fails to respond to standard treatments

Prevention and Treatment

Whether your shortness of breath is related strictly to GERD or is due to GERD-related asthma, there are steps you can take to prevent and treat it. Often, the most effective steps involve controlling or adjusting personal behavior. Here are a few recommendations:

  • Raise the head of your bed by four to eight inches. This allows gravity to help keep your stomach’s contents where they belong. Don’t use piles of pillows—this puts your body into a bent position that can aggravate GERD symptoms and may cause breathing difficulty by increasing pressure on the abdomen. Instead, use a special wedge-shaped pillow available at many maternity stores and medical supply shops.
  • Eat meals at least three to four hours before lying down on the couch or bed, and avoid bedtime snacks.
  • Eat smaller, more frequent meals to avoid eating too much in one sitting.
  • Lose weight if needed to eliminate abdominal pressure caused by extra pounds.
  • Depending on individual tolerance, limit consumption of foods and drinks that you’ve identified as triggers for GERD symptoms, including breathing difficulties. These may include fatty foods, chocolate, peppermint, coffee, tea, alcohol (which relax the lower esophageal sphincter), tomatoes, and citrus fruits or juices (which can cause acid that can irritate your esophagus).
  • Don’t smoke. Smoking relaxes the lower esophageal sphincter, which can cause GERD symptoms.
  • Avoid wearing tight belts and clothing that put pressure on your abdomen.
  • If you have both GERD and asthma, continue to take your prescribed asthma medications (and medications for GERD if your doctor has prescribed them)—and limit exposure to your asthma and GERD triggers.

If lifestyle changes alone don’t improve reflux-related breathing problems, doctors may treat narrowing of the esophagus by artificially enlarging  it during a procedure called dilation. This can be achieved by using balloons or progressively larger dilators. Your doctor may also recommend drug treatments for GERD symptoms and, in rarer cases, surgery.

The Mayo Clinic notes that shortness of breath in conjunction with chest pain can be a sign of a heart attack rather than GERD. Shortness of breath has many possible causes and can be deadly if not properly treated. If in doubt, seek immediate medical attention.

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