Effects of Acid Reflux on Asthma

Woman with hand on stomach with heartburn
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While research studies have shown a relationship between acid reflux and asthma, we still do not know if acid reflux actually causes asthma. This is somewhat of a double-edged sword: Acid reflux may cause asthma symptoms, but asthma medications may also worsen acid reflux symptoms. It is much like the chicken and the egg of which came first.

If you cannot explain why you are having asthma-like symptoms, you may want to talk to your doctor about considering a diagnosis of acid reflux or starting on a therapeutic trial to see if your symptoms improve.

If your asthma is poorly controlled and you are experiencing any of the following symptoms of acid reflux or asthma, you may want to consider talking about acid reflux with your doctor:

Your doctor is most likely to look at acid reflux as a cause of your asthma or worsening asthma symptoms if your asthma:

  • Started in adulthood
  • Worsens after lying down or with vigorous exercise
  • Is poorly controlled despite good medical treatment

How Acid Reflux May Worsen Your Asthma

Acid reflux may cause asthma or worsen asthma symptoms through a couple different mechanisms:

  • Increased pulmonary resistance: When acid goes from your stomach into your esophagus, the irritation can lead to asthma symptoms as nerve stimulation in the esophagus causes bronchospasm.
  • Micro-aspiration: When small amounts of acid move from your stomach into your lungs, bronchoconstriction may result directly due to hyperresponsiveness.

What You Can Do About Acid Reflux

There are a number of home treatments that you can try if GERD is making your asthma worse. These include:

  • Taking over the counter GERD medications as needed. These are often the same medications your doctor may prescribe but in lower dosages.
  • Eating small, but more frequent meals to decrease the risk of reflux.
  • Elevate the head of your bed if the symptoms seem to be leading to nighttime asthma symptoms.
  • Maintain a healthy weight as being overweight increases abdominal pressure and causes the acid in your stomach to be pushed into your esophagus.
  • Avoid or at least consume in moderation foods that are known to make GER worse such as fried foods, tomato sauce based food, alcohol, chocolate, and caffeine.
  • Do not recline for 3 hours after eating.
  • Quit smoking. The tobacco and nicotine may lead to dysfunction of the lower part of the esophagus that prevents reflux. Quitting smoking is one of the single best things you can do for asthma and overall health.
  • There are also a number of alternative medicine treatments you may try such as licorice, slippery elm, or marshmallow.

If your doctor thinks that you have acid reflux but is not able to make a diagnosis or if none of the home or prescribed treatments seem to work, your doctor may refer you to a gastroenterologist—a specialist in the treatment of stomach and bowel disorders.

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