Asthma is a respiratory condition that affects the airways. Gastroesophageal reflux disease (GERD) is a condition where stomach contents travel back up the esophagus towards the throat.
Asthma and acid reflux often occur together. Acid reflux can worsen asthma and asthma can worsen acid reflux.
Asthma and acid reflux can occur together in children as well as in adults. In fact, about half the children with asthma also have GERD.
GERD and asthma may trigger each other due to the connection between the esophagus, stomach, and airways, as well as side effects of certain asthma medications.
GERD and asthma may have a link due to the following: nerves in the lower esophagus connect to nerves in the lungs, which means GERD symptoms may trigger asthma symptoms, small particles from acid reflux can enter the airways and aggravate asthma symptoms and muscles at the base of the esophagus can relax during an asthma flare, causing contents from the stomach to flow back up towards the throat.
GERD can Trigger Asthma
The repeated flow of stomach acid into the esophagus damages the lining of the throat and the airways to the lungs. This can lead to breathing difficulties as well as a persistent cough. The frequent exposure to acid may also make the lungs more sensitive to irritants, such as dust and pollen, which are all known to trigger asthma.
Acid reflux triggers the vagal nerve, which causes the lungs to become more sensitive to asthma triggers, such as irritants or allergens. Acid reflux may trigger a protective nerve reflex. This nerve reflex causes the airways to tighten in order to prevent the stomach acid from entering the lungs. The narrowing of the airways can result in asthmatic symptoms, such as shortness of breath.
Asthma can Trigger GERD
People who have asthma have a higher risk of GERD. At the lower end of the esophagus, there are a group of muscles called the lower esophageal sphincter ( LES ). When the esophageal sphincter closes, the muscles prevent stomach acid or contents from traveling back up towards the throat. During an asthma flare-up, pressure changes occur inside the chest and abdomen. This causes the esophageal sphincter to relax, which can cause stomach acid or contents to travel back into the esophagus.
Some asthma medications, such as theophylline, may also worsen acid reflux. The overuse of quick-relief inhaler medications, can also trigger GERD. This is because they also relax the esophageal sphincter.
Risk Factors for GERD
The estimated number of inpiduals suffering from GORD globally is 1.03 billion. Recent studies show that GERD in infants and children is more common than doctors thought. It can cause vomiting that happens over and over again. It can also cause coughing and other breathing problems.
Hiatal hernia may weaken the LES and raise your chances of gastroesophageal reflux. Hiatal hernia happens when the upper part of your stomach moves up into the chest through a small opening in your diaphragm (diaphragmatic hiatus). The diaphragm is the muscle separating the abdomen from the chest. Recent studies show that the opening in the diaphragm helps support the lower end of the esophagus. Having a hiatal hernia may allow stomach contents to reflux more easily into the esophagus.
Coughing, vomiting, straining, or sudden physical exertion can raise pressure in your belly and lead to a hiatal hernia. Many otherwise healthy people ages 50 and over have a small one. Although it’s usually a condition of middle age, hiatal hernias affect people of all ages.
Hiatal hernias usually don’t need treatment. But it may be necessary if the hernia is in danger of becoming strangulated, or twisted in a way that cuts off blood supply. You may also need to treat it if you have one along with severe GERD or inflammation of the esophagus.
Several other factors can make it more likely to have GERD: being overweight or obese, pregnancy, delayed emptying of the stomach, diseases of connective tissue such as rheumatoid arthritis, scleroderma, or lupus.
Diet and lifestyle choices may make acid reflux worse if you already have it as smoking, certain foods and drinks, including chocolate , fatty or fried foods, coffee, and alcohol, large meals, eating too soon before bed and certain medications, including aspirin.
Can Stress Cause Acid Reflux?
It’s still debatable whether or not stress actually increases the production of stomach acid or physically creates a worsening in acid. Currently, many scientists believe that when you’re stressed, you become more sensitive to smaller amounts of acid in the esophagus.
People with acid reflux who were anxious and stressed reported having more painful symptoms related to acid reflux, but no one showed an increase in gastric acid. In other words, though people consistently reported feeling more discomfort, the scientists didn’t find any increase in total acid produced.
Another study added further support to this idea. When researchers exposed people with GERD to a stressful noise, they also found that it increased their symptoms by making them more sensitive to acid exposure.
Stress may cause changes in the brain that turn up pain receptors, making you physically more sensitive to slight increases in acid levels. Stress can also deplete the production of substances called prostaglandins, which normally protect the stomach from the effects of acid. This could increase your perception of discomfort. Stress, coupled with exhaustion, may present even more body changes that lead to increased acid reflux.
Symptoms of GERD
Symptoms of GERD can include: acid reflux, heartburn, unpleasant taste in the mouth, nausea, chest pain, difficulty swallowing, hoarse voice, sore throat, or problems with the mouth or throat, excess saliva, inflamed gums, cavities and bad breath.
If you have acid reflux at night, you may also have a lingering cough, laryngitis, asthma that comes on suddenly or gets worse and sleep problems.
Tips to help manage GERD
Avoiding eating 2–3 hours before sleeping, raising the head of the bed by 6–8 inches to elevate the upper body, as just raising the head with extra pillows is not effective , eating smaller meals and limiting large, heavy meals, particularly before sleeping, maintaining a healthy weight and avoiding smoking.
Dietary changes may also help, and people may need to avoid acidic foods, such as citrus fruits, fried foods, fatty foods, spicy foods, chocolate, caffeine, mint and alcohol.
Tips to Help Control Asthma
Understanding and avoiding personal asthma triggers, managing stress, getting the flu vaccine each year, taking medications as a doctor prescribes, developing an asthma action plan with a doctor and avoiding tobacco smoke, including second-hand smoke.
If possible, avoiding outdoor activities when air quality is poor, cleaning regularly and considering air purifiers to improve indoor air quality, attending regular checkups, maintaining a healthy weight, eating heart-healthy foods, such as plenty of fruit and vegetables, and ensuring adequate vitamin D, exercising regularly and maintaining healthy sleep habits.
Exercise helps loosen up tight muscles, gets you away from the office, and releases natural, feel-good hormones. Exercise can also help you lose weight, which can help reduce the pressure on your abdomen.