What is the Connection Between Acid Reflux and Asthma?

Acid reflux and asthma are closely linked conditions. Many people with asthma also have acid reflux disease and episodes of acid reflux can worsen asthma symptoms. Treating the acid reflux will help ease the patient's asthma symptoms and increase patient comfort. A patient with asthma who experiences random wheezing, nighttime coughing, burning sensations in the throat, and a hoarse voice may want to be evaluated for acid reflux. It is important to be aware that in laryngopharyngeal reflux, also known as silent acid reflux, heartburn is not present, and the patient can be sick without having the classic symptoms associated with acid reflux disease.
In patients with acid reflux and asthma, when stomach acid rises up the esophagus and irritates the area around the larynx, it can trigger a sympathetic response in the bronchial passages. The bronchial passages are designed to keep anything other than air out of the lungs. When they sense the presence of stomach acid, they narrow down, leading to coughing and wheezing for the patient. Using an inhaler should help the patient breathe more easily by forcing the passages to open up again.

Some asthma medications have been linked with an increase in acid reflux. These medications are used with care and the patient may be prescribed an acid reflux medication as a preemptive measure. Patients with acid reflux and asthma can use measures to control their acid reflux to help them manage their asthma. This can include making dietary changes, taking medications, undergoing surgery, and wearing loose clothing that does not compress the abdomen.

In patients with silent acid reflux and asthma, the explanation for the troublesome asthma symptoms may not readily be apparent. An exam will be needed to identify the signs of laryngopharyngeal reflux in the patient's throat. Patients may find it helpful to keep a diary noting when asthma symptoms improve and grow worse, as this may establish a pattern to explain the patient's symptoms and may demonstrate an acid reflux and asthma connection.

Between 50 and 80 percent of patients with asthma also have acid reflux. Asthma patients should be aware that their chances of having acid reflux are much higher than in the general population. They may want to consider taking proactive steps to prevent reflux episodes and they should talk to their doctors about evaluation for acid reflux if their current asthma treatment plans are not working and they have not been examined for signs of acid reflux disease.
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Discussion Comments
I think that one theory may explain this connection is nerves. There are major nerves that travel through the stomach and into other organs. So if we have a problem in one part of our body, it can have consequences in the function of our stomach. That's why some people have upset stomach, acidity, nausea and vomiting when they're stressed or anxious. Their psychological state causes a physiological response in the stomach.
Why can't the same be true for asthma suffers? The stress caused by an asthma attack or the contraction of muscles surrounding the lungs can easily trigger acid production in the stomach by stimulating those nerves. What do you guys think?
@burcinc-- I've been reading about this topic for a while now as a sufferer of both asthma and acid reflux. As far as I know, the connection between acid reflux and asthma hasn't entirely been proven. Doctors believe that there is a connection but they're not entirely sure which triggers which and why. The evidence they've found so far seems to support that acid reflux worsens asthma by triggering the inflammatory response. The acid irritates the nerves in the bronchi, which causes an asthma attack.
Aside from medications though, I haven't really seen evidence of how asthma causes acid reflux if it indeed does. But the way I see it, at least half of all asthma sufferers wouldn't also have acid reflux if there wasn't some kind of connection. It can't be a coincidence.
I personally feel better and breathe better when my acid reflux is under control. I carry antacid medication with me all the time.
I can see how acid reflux would cause asthma -- by irritating the bronchial passages. But I don't understand how asthma increases the risk of acid reflux. Do all asthma sufferers use medications all the time?! My friend has asthma and she has an inhaler. But I've only seen her use it twice. She doesn't use anything on a regular basis. So I don't understand why someone who doesn't take asthma medication regularly would experience acid reflux as a result of this condition. Can anyone explain?
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