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Asthma and GERD

Topic Overview

Gastroesophageal reflux disease (GERD) is the abnormal backflow, or reflux, of stomach juices into the esophagus, the tube that leads from the throat to the stomach.

GERD is found in many people who have asthma. Having asthma increases the chances of developing GERD.

Some experts debate whether or to what extent GERD makes asthma worse. Studies have shown conflicting results as to whether GERD triggers asthma.1

Those experts who believe GERD does trigger asthma theorize that the abnormal backflow of stomach juices irritates nerves in the esophagus. This could make the smooth muscles of the bronchial tubes tighten, causing airway narrowing. Or food may back up into the throat and airway, causing direct irritation of the bronchial tubes.

People with asthma who have heartburn—after meals, when they bend over, or when they lie down—may need to be treated for GERD. If you have persistent nighttime asthma symptoms, especially coughing and wheezing, GERD could be making your asthma symptoms worse. Simple steps you can take that may reduce the symptoms of GERD include losing weight (if needed), eating a low-fat diet, raising the head of your bed, and not eating for at least 3 hours before you go to bed.

Studies show mixed results on whether treatment for GERD improves asthma symptoms or lung function or reduces the need for medicines.

  • One review of studies concluded that treatment for GERD did not result in consistent improvement in asthma symptoms.1
  • One study showed that people with poorly controlled asthma and GERD who received GERD treatment using esomeprazole did not have any significant improvement in their asthma.2
  • Another study noted that after taking medicines for GERD (proton pump inhibitor and a prokinetic agent) for 6 months, older children with GERD and asthma needed less asthma medicine.3

For more information about GERD, see the topic Gastroesophageal Reflux Disease (GERD).

References

Citations

  1. Gibson PG, et al. (2003). Gastro-esophageal reflux treatment for asthma in adults and children. Cochrane Database of Systematic Reviews (1). Oxford: Update Software.
  2. American Lung Association Asthma Clinical Research Centers (2009). Efficacy of esomeprazole for treatment of poorly controlled asthma. New England Journal of Medicine, 360(15): 1487–1499.
  3. Khoshoo V, et al. (2003). Role of gastroesophageal reflux in older children with persistent asthma. Chest, 123(4): 1008–1013.

Credits

By Healthwise Staff
E. Gregory Thompson, MD - Internal Medicine
Rohit K Katial, MD - Allergy and Immunology
Last Revised February 22, 2013

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