GERD and Asthma: What You Need to Know
Did you know that more than a third of people who have asthma also have a condition called gastroesophageal reflux disease, or GERD for short? And did you know that having GERD can greatly affect the degree of asthma control you have?
It's true. It may seem a little strange that an inflammatory condition of the airways could be related to a condition affecting the gastrointestinal tract. But, if you've seen my post on the link between gut health and asthma, then it may make more sense.
What is GERD?
GERD, also called acid reflux, is a disorder that occurs when your stomach contents back up into your esophagus, or feeding tube. This happens when the muscle separating your stomach and your esophagus isn't working correctly. This muscle is called a sphincter.
Most everyone experience occasional acid reflux. Have you ever had heartburn, burped or noticed an acidic taste in your mouth? That's reflux. It's when these things occur on a regular basis that a diagnosis of GERD may be made.
Here are some of the common symptoms of GERD:
- Acid regurgitation (when you taste your food after eating)
- Difficulty swallowing
- Sudden excess of saliva
- Chronic sore throat or hoarseness
- Inflammation of your gums
- Bad breath
If any or all of these symptoms begin to interfere with your life, then it's time to see a doctor, who can test you for GERD. Common diagnostic tests include x-rays, endoscopy and other tests of your esophagus' function.
How does GERD relate to asthma?
We are still not sure if GERD can cause asthma or vice versa. Here's what we do know:
- People with asthma are at much higher risk of developing GERD than the general population.
- Asthma flare-ups can trigger GERD by relaxing the sphincter muscle and causing regurgitation. (Some asthma medicines, such as theophylline, can make this worse.)
- Acid reflux can make asthma symptoms worse by irritating the airways and lungs. If left unchecked, this can result in serious asthma control issues.
- Your irritated airways can trigger an allergic reaction, making them even more sensitive to environmental conditions such as smoke or cold air.
In people who have both GERD and asthma, when GERD is well-controlled, asthma control tends to follow.
How is GERD treated?
So, clearly it's important to take control of your GERD! Here are a few tips for doing that:
- Elevate the head of your bed 6 to 8 inches.
- Lose weight, if you need to.
- If you smoke, quit.
- Drink less alcohol.
- Limit the size of your meal portions, especially in the evening.
- Don't lie down until two or three hours after eating.
- Cut down on caffeinated drinks.
Medication is another option. Examples of medicines used to treat GERD are antacids, H2 blockers and proton pump inhibitors. Some are available over the counter, while others must be prescribed by a doctor. In either case, it's wise to consult with your doctor first before starting any new treatment.
If lifestyle changes and medication do not help GERD, surgical options may be considered.
What Else Do You Need to Know?
Some people with asthma have what is known as "silent GERD." This means that while testing can detect this disorder, the typical symptoms listed above are not particularly noticeable.
However, if you are having trouble with asthma control, especially at night, you should suspect GERD.
Current asthma treatment guidelines recommend that physicians consider prescribing a trial of antireflux therapy to patients with poorly controlled asthma, even in the absence of GERD symptoms.
In general, people whose GERD is well-managed will experience improvements in their asthma symptoms as well, not to mention their quality of life. It's crucial to keep in touch with your doctor, though. Let him/her know how you are feeling, whether it's better than before, or worse. If all else fails, you may need to see a GI specialty doctor.
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