Asthma and Acid Reflux: Is There a Connection?
If you or a loved one struggle with both asthma and acid reflux, you may be wondering if there’s a relationship between the two conditions. The short answer is yes.
What Is Asthma?
Asthma is a serious medical condition that results in a person's airways becoming inflamed. When the inflammation is severe enough, airways swell and become narrowed or closed off. This makes it hard to get enough oxygen. You might feel short of breath, meaning you can’t get enough air into your lungs. You may also experience coughing, wheezing, and chest pain during an asthma attack. Although living with a condition that can make it difficult to breathe is frightening, it's extremely common and can be treated.
What triggers asthma attacks?
The causes of asthma attacks are different for most everyone although there are some common causes including:
- Allergies
- Exercise
- Exposure to chemicals, dust or fumes in the workplace
- Acid reflux
What Is Acid Reflux?
Acid reflux is more than just the occasional heartburn experienced by eating something too spicy or fatty. Most Americans experience heartburn every now and then, caused by acid that comes back up into the esophagus. When acid reflux becomes chronic, it's known as gastroesophageal reflux disease (GERD), a condition that results from the weakening of the upper esophageal sphincter. This is the valve that allows food to enter the stomach from the esophagus but is designed to immediately close to prevent backflow.
In a person with GERD, the valve is flimsy or loose and doesn't close after food enters the stomach. This allows food, bile, and stomach acid to be pushed back up into the esophagus. In some cases, a patient may reflux into their mouth or sinuses, a condition known as pharyngoesophageal reflux.
Causes of Acid Reflux
- Genetics
- Being overweight or obese
- Overeating
- Hiatal hernias
- Taking medications that are hard on the stomach, like ibuprofen or aspirin
- Eating foods that relax or irritate the upper esophageal sphincter, like chocolate, caffeine, or alcohol
How Are Asthma and Acid Reflux Connected?
While many people have both asthma and acid reflux they’re not always related. Patients with chronic acid reflux may notice that they get sick with colds or flus more frequently, or that bouts of pneumonia are hard to get rid of. Breathing in stomach contents during a reflux episode can also lead to the worsening of asthma symptoms, such as wheezing and coughing. It may also cause a sudden asthma attack that requires emergency treatment.
Talk to your doctor if you have asthma - it may actually be caused by acid reflux. Many people get diagnosed as adult onset asthma that is caused by the reflux. This happens when the stomach acid comes up far enough into the esophagus that a small amount can be inhaled into the lungs. Many times people do not feel any acid reflux symptoms like heartburn or chest pain, but the only symptom they experience is a cough or asthma. This is referred to as silent reflux.
Other patients area aware of their acid reflux but with reflux medications the GERD symptoms resolve. Unfortunately, the cough and/or asthma will not resolve because stomach contents are still refluxing up the esophagus into the lungs, they are just not as acidic because of the medications, but the medications do not stop the reflux, only the burning - thus allowing stomach contents to still be inhaled into the lungs.
Tips for Reducing Acid Reflux
The following tips are good for anyone who suffers from acid reflux, but can be especially helpful if you also have asthma.
- No eating at least an hour or two before bed. Your body's digestion slows down more at night so your energy reserves can be focused on getting the rest you need. Eating too soon before bed means that you won't be digesting food while you're asleep and the contents of your stomach will stay there longer. When you lie down, it's easier for acid to reach your lungs, especially when you have a full stomach.
- Sleep in a reclined position. Sleeping somewhat upright, such as in a recliner or an adjustable bed, can help you use gravity to your advantage to keep the contents of your stomach in your stomach, where it belongs.
- Lay on your left side. The human stomach has a built-in space to hold gas and excess food called the fundus. This is what gives the stomach its "J" shape. The fundus is on the left side of your body and helps keep the contents of your stomach from being pushed up through the esophagus by giving it another place to go. When you sleep or lie down on your left side, acid will go into this part of your stomach instead of refluxing.
- Wear loose-fitting pants. If you wear jeans or pants with a tight waistband, this puts constant pressure on your belly, pushing the contents of your stomach up against your upper esophageal sphincter every time you move. Instead, wear loose pants or low-waisted pants that don't cut you off at your navel or above.
- Avoid triggering foods. Certain foods are extremely triggering for acid reflux and can significantly worsen symptoms.
- Chocolate and coffee naturally weaken the upper esophageal sphincter, making it easier for you to reflux in the first place.
- Foods like citrus and tomato burn more on the way back up and can cause your esophagus to feel raw and inflamed.
- Other foods to avoid when you have acid reflux include but aren't limited to alcohol, garlic, onions, spicy foods, carbonated beverages, black and white pepper, and peppermint.
If you also have asthma, breathing in extra-spicy acid is more likely to trigger an asthma attack. Instead, choose alkaline foods like fresh green vegetables, non-citrus fruits, root vegetables, lean meats like chicken and fish, and minimally processed foods.
- Bend at the knees to pick something up instead of bending at the waist. For the same reason that tight pants can push acid in your stomach up through your esophagus, so can bending over at the waist. If you've ever bent over and felt a rush of liquid into your mouth, it's safe to say your esophageal sphincter could use a little extra care. Instead, bend at the knees and squat to pick something up so your torso remains straight.
Learn More About Surgical Options to Treat Acid Reflux
Medications and lifestyle changes can help, but won’t resolve GERD. For many people, surgical options to treat acid reflux are an excellent, more permanent solution to the daily distress of living with the discomforts of GERD and GERD caused issues like chronic cough and asthma. If your acid reflux is triggering your asthma symptoms or causing more asthma attacks than usual, it's even more important that you look into a surgical treatment.
Drew D. Howard, MD is a Houston area bariatric and gastric surgeon that specializes in four types of surgical acid reflux management, including the laparoscopic hiatal hernia repairs, the Nissen Fundoplication, the TIF procedure, and the LINX procedure. During your appointment, we will go over your medical history in-depth and complete an evaluation to determine if acid reflux surgery is right for you. Schedule an appointment at our office in The Woodlands, Texas.
Categories: Acid Reflux & GERD