Difficulty breathing is one of the more frightening symptoms of acid reflux and the chronic form of the condition, which is called gastroesophageal reflux disease (GERD). GERD can be associated with breathing difficulties such as bronchospasm and aspiration. These difficulties can sometimes lead to life-threatening respiratory complications.
Shortness of breath, also called dyspnea, occurs with GERD because stomach acid that creeps into the esophagus can enter the lungs, particularly during sleep, and cause swelling of the airways. This can lead to asthma reactions or cause aspiration pneumonia. Such airway damage can affect breathing by causing coughing or wheezing.
Shortness of breath can occur in GERD alone, but it also often occurs in conjunction with asthma. The two conditions are often linked. In fact, the Cleveland Clinic estimates that:
- more than three-quarters of people with asthma also experience GERD
- people with asthma are twice as likely as those without asthma to have GERD
- people 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. This can bring about an asthma attack in those who have preexisting asthma. Another reason may be that when acid enters the esophagus, it triggers a nerve reflex that causes airways to constrict to keep acid out. This 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
- worsens after stress, eating, exercise, lying down, or at night
- fails to respond to standard treatments
Whether your shortness of breath is related strictly to GERD or is due to GERD-related asthma, there are small steps you can take to prevent and treat it. Often, the most effective steps to prevent GERD involve making some lifestyle changes. Here are some tips:
- Modify your diet. Eat smaller, more frequent meals, and avoid bedtime snacks or meals.
- Lose weight if you are overweight.
- Identify triggers for GERD symptoms and avoid them. For example, if tomato sauce irritates your GERD, avoid foods and meals that contain tomato sauce.
- Quit smoking and reduce or eliminate alcohol intake. Smoking and alcohol consumption can aggravate GERD symptoms.
- Elevate the head of your bed by 4 to 8 inches. This helps the food in your stomach remain there instead of traveling into your esophagus while you’re sleeping.
- Avoid using too many pillows when you sleep. This can put your body into an awkward position that worsens your GERD symptoms.
- Avoid wearing tight belts and clothing that puts pressure on your abdomen.
If lifestyle changes alone don’t improve reflux-related breathing problems, your doctor may also recommend drug treatments for GERD symptoms. Drugs that your doctor may recommend include antacids, H2 receptor blockers, and proton pump inhibitors. In rare cases, surgery is needed.
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.