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Nineteen million Americans, from infants to seniors, suffer from gastroesophageal reflux disease (GERD). If you have asthma, your chances of having GERD are higher than those without the condition. Studies show that as many as 70% of patients with asthma have GERD compared to 20%-30% of the general population.

What is GERD?

After you eat, a part of your digestive system called the lower esophageal sphincter usually remains closed as you digest your food. However, sometimes it relaxes on the job, allowing stomach acid to flow back, or reflux, into the esophagus.

Heartburn is the most common symptom caused by gastro esophageal reflux. Almost everyone has experienced heartburn at one time or another. In addition one can have NO symptoms this is called “silent reflux”. Other symptoms that occur less frequently but can also indicate that you could have GERD are:

  • Acid regurgitation (retasting your food after eating)
  • Difficulty or pain when swallowing
  • Sudden excess of saliva
  • Chronic sore throat
  • Laryngitis, hoarseness
  • Inflammation of the gums
  • Cavities
  • Sour taste
  • Bad breath
  • Chest pain
Although symptoms of GERD are common, often the condition is not diagnosed and symptoms go untreated. For patients with asthma, untreated reflux could mean uncontrolled asthma.

The airway connection

Why does GERD occur so frequently in patients with asthma? Changes in pressure in the chest that occur during airway obstruction in asthma can actually help to relax the sphincter at the bottom of the esophagus that controls the flow of stomach contents. The end result is that more negative pressure in the chest can cause stomach contents to flow up the esophagus rather than down. Acid in the esophagus can irritate the lungs either directly by aspiration into the lung or indirectly via stimulation of nerves. This can make the airways more irritable or hyperreactive to other triggers, like cold air, pollen, smoke, etc. Although studies have shown a relationship between asthma and GERD, researchers are not certain of the exact interaction. Reflux may worsen asthma symptoms; on the other hand, asthma and some asthma medications, especially theophylline, may worsen reflux symptoms.

This cycle of reflux and airway obstruction may contribute to the development of progressively worsening asthma and other pulmonary disease. Severe, chronic and treatment-resistant asthma is more likely to be associated with GERD. Obesity, asthma and GERD are all interrelated. So if you are overweight you are more likely to have reflux and asthma as well.

Reference: AAAAI patient information