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GERD and Asthma

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Updated April 16, 2014

Several studies suggest a significant link between GERD and asthma. The results of these studies show that up to 60% of people with asthma also have gastroesophageal reflux disease (GERD), compared with 10% of the general population.

GERD may worsen asthma symptoms, however, asthma and some asthma medications may worsen GERD symptoms. On the other hand, treating GERD often helps to also relieve asthma symptoms, further suggesting a relationship between the two conditions.

Although doctors do not fully understand the connection between GERD and asthma, they have found that treating a patient's GERD symptoms will often relieve asthma symptoms as well.

How Can GERD Affect Asthma?

  • Refluxed acid from the stomach can be aspirated into the airways and lungs, making breathing difficult and causing the patient to cough.

  • A triggered nerve reflex causes the airways to narrow. This will then cause shortness of breath.

How Can Asthma Affect GERD?

  • Some asthma medications (such as oral or intravenous bronchodilators) may trigger GERD symptoms. They can do this by relaxing the lower esophageal sphincter (LES), allowing stomach contents to reflux into the esophagus and possibly be aspirated into the lungs. However, most inhaled bronchodilators used in the U.S. do not cause this problem.

What to Do if You Have GERD and Asthma

Working with your physician is important. It is important to take any medication your doctor prescribes consistently. This applies both to those medications prescribed for your asthma and for your GERD. It is also important to control your exposure to asthma and heartburn triggers as much as possible. Your doctor and you can discuss what your asthma and heartburn triggers are, and how best you can avoid them.

The next step is to take a few preventative steps to control GERD symptoms. These include:

  • Sleep with your head and shoulder on an incline.
    Lying down flat presses the stomach's contents against the LES. With the head higher than the stomach, gravity helps reduce this pressure, and keeps stomach contents where they belong--in the stomach. You can elevate your head in a couple of ways. You can place bricks, blocks or anything that's sturdy securely under the legs at the head of your bed. You can also use a wedge-shaped pillow to elevate your head.

  • Sleep on your left side.
    Studies have shown that this position aids digestion and helps with the removal of stomach acid. Sleeping on the right side has been shown to worsen heartburn.

  • Eat at least two to three hours before lying down.
    If you take naps, try sleeping in a chair. Lying down with a full stomach can cause stomach contents to press harder against the LES, increasing the chances of refluxed food.

  • Avoid foods that are known to lead to heartburn.
    These include foods that can trigger your heartburn, either by increasing acid production and gastric pressure or by loosening the lower sphincter muscle. Also, avoid foods that can irritate the lining of the esophagus, such as spicy foods, coffee, citrus fruit and juices. If you eat any of these foods at dinnertime, you will increase your chances of having nighttime heartburn. If you aren't sure what foods trigger your heartburn symptoms, try keeping a heartburn record for a week. You can also check out a chart for foods with little risk of causing heartburn.

  • Eliminate late-night snacking.
    Have your last snack no later than two hours before bedtime.

  • Stop smoking.
    Nicotine can weaken the lower esophageal sphincter, which can lead to stomach contents entering the esophagus, with heartburn as a result. Smoking also stimulates the production of stomach acid. Find out the other reasons it's good to stop smoking if you suffer from heartburn.

  • Avoid alcohol.
    Alcohol increases the production of stomach acid. Alcohol also relaxes the lower esophageal sphincter (LES), allowing stomach contents to reflux back up into the esophagus. If you still want to consume alcohol, find out how and when to consume alcohol when you suffer from heartburn.

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Sources:
"The association between gastro-oesophageal reflux disease and asthma: a systematic review." Gut: International Journal of Gastroenterology and Hepatology. 6 August 2007. 14 Nov 2007

"Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD)." NIH Publication No. 07–0882 May 2007. National Digestive Diseases Information Clearinghouse (NDDIC). 14 Nov 2007

"What are some severe complications and atypical manifestations of GERD?." American College of Gastroenterology. 14 Nov 2007

"Straight Answers to Your Questions about Heartburn & GERD." American College of Gastroenterology. 14 Nov 2007

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