People with asthma are more likely than those without asthma to develop the chronic form of acid reflux known as gastroesophageal reflux disease (GERD) at one time or another.
The exact connection between GERD and asthma isn’t entirely clear. Researchers have a few theories as to why the two conditions may coincide.
One possibility is that the repeated flow of stomach acid into the esophagus damages the lining of the throat and the airways to the lungs. This can lead to breathing difficulties and a persistent cough.
Frequent exposure to acid may also make the lungs more sensitive to irritants, such as dust and pollen, which are all known to trigger asthma.
Another possibility is that acid reflux may trigger a protective nerve reflex. This nerve reflex causes the airways to tighten to prevent stomach acid from entering the lungs.
The narrowing of the airways can result in asthmatic symptoms, such as shortness of breath.
Just as GERD can make asthma symptoms worse, asthma can exacerbate and trigger symptoms of acid reflux. Pressure changes that occur inside the chest and abdomen during an asthma attack, for example, are believed to aggravate GERD.
As the lungs swell, the increased pressure on the stomach may cause the muscles that usually prevent acid reflux to become lax. This allows stomach acid to flow back up into the esophagus.
Heartburn is the main GERD symptom adults experience. However, in some people, GERD can occur without causing heartburn. Instead, symptoms may be more asthmatic in nature, such as a chronic dry cough or difficulty swallowing.
Your asthma may be connected to GERD if:
- it began in adulthood
- symptoms get worse following a large meal or exercise
- symptoms occur while drinking alcohol
- symptoms 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 under age 1 will often experience symptoms of acid reflux, such as frequent spitting up or vomiting, with no harmful effects.
In general, infants and young children with GERD will:
- become irritable
- arch their backs often (usually during or immediately following feedings)
- refuse to eat
- experience poor growth (both in terms of height and weight)
In older toddlers and children, GERD may cause:
- nausea
- heartburn
- repeated regurgitation
- symptoms of asthma, such as coughing, shortness of breath, and wheezing
Medications
Until recently, it was believed that managing “silent” acid reflux with proton pump inhibitors (PPIs), such as esomeprazole (Nexium) and omeprazole (Prilosec), would also help relieve asthmatic symptoms.
A 2009 study published in the New England Journal of Medicine questioned the drugs’ effectiveness in treating severe asthma attacks.
During the nearly 6-month study, there was no difference in the rate of severe attacks between people taking medication and those taking a placebo.
Before the study, researchers estimated that 15% to 65% of people with asthma took PPIs to manage GERD symptoms and control severe asthma attacks.
Due to the suspected ineffectiveness of these drugs, those with asthma may want to consider other medications to treat their condition.
Some commonly used asthma medicines, such as theophylline and beta-adrenergic bronchodilators, may even aggravate acid reflux.
Consult with your healthcare professional before changing or stopping your asthma medications.
Lifestyle and home remedies
Since medications may be ineffective in the treatment of asthma and GERD simultaneously, you can try lifestyle and home remedies to see if they help.
To help manage or prevent GERD symptoms, you can try:
- avoiding foods or drinks that contribute to acid reflux
- eating smaller meals more often instead of eating larger meals three times a day
- eating meals at least 3 to 4 hours before bedtime
- using a wedge pillow or raising the head of the bed 6 to 8 inches by placing blocks underneath bedposts
- wearing loose clothing and belts
- maintaining a moderate weight
- quitting smoking, if applicable
Surgery is usually an effective last resort in treating GERD when these strategies and treatments don’t work.
A few strategies for avoiding acid reflux in children include:
- burping infants several times during feeding
- keeping infants in an upright position for 30 minutes after feeding
- feeding children smaller, more frequent meals
- not feeding children foods that can trigger acid reflux (noted above)
To relieve asthma symptoms, you may want to consider:
- Exercise: Techniques such as yoga, tai chi, and deep breathing can help improve lung function and reduce stress.
- Honey: Honey has been used traditionally for its anti-inflammatory properties. Some people find relief from asthma symptoms by consuming a teaspoon of honey mixed with warm water before bedtime. However, honey shouldn’t be given to children under one year of age due to the risk of botulism.
- Ginger and turmeric: Both contain compounds with anti-inflammatory properties that may help alleviate asthma symptoms. You can consume ginger or turmeric tea or add grated ginger or turmeric to your meals.
- Omega-3 fatty acids: Foods rich in omega-3 fatty acids, such as fatty fish and flaxseeds, may help reduce inflammation in the body, including inflammation in the airways.
- Essential oils: Certain essential oils, such as eucalyptus and lavender, have been used for their potential bronchodilator and anti-inflammatory effects. However, it’s important to use caution, as it can trigger asthma symptoms in some individuals. Inhalation methods such as diffusing or steam inhalation are preferred over direct application to the skin.
What does GERD-induced asthma feel like?
The experience of GERD-induced asthma varies from person to person. Symptoms often include wheezing, coughing, shortness of breath, chest tightness, heartburn, regurgitation, difficulty swallowing, and hoarseness.
Does an inhaler help with GERD?
While inhalers aren’t designed to treat GERD, they can help alleviate symptoms of GERD-induced asthma by providing relief from asthma symptoms such as wheezing, coughing, and shortness of breath.
However, it’s important to note that inhalers do not address the underlying cause of GERD.
How do you treat GERD breathing problems?
GERD breathing problems are treated with medications like proton pump inhibitors, lifestyle changes including dietary adjustments and weight management, and respiratory treatments like inhalers.
Seek medical attention if symptoms persist despite over-the-counter treatments, interfere with daily activities, or worsen over time.
If you have a history of asthma or GERD, or if you suspect a connection between the two conditions, consult a healthcare professional for evaluation and appropriate management.
Early intervention can help prevent complications and improve quality of life.