Gastroesophageal reflux disease (GERD)

It is estimated that more than 75 percent of patients with asthma also experience gastroesophageal reflux disease (GERD), the backward flow of stomach acids into the esophagus. People with asthma are twice as likely to have GERD as people without the condition--and those who have a severe, chronic form that is resistant to treatment are most likely to also have GERD.

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When acid enters the lower part of the esophagus, it can produce a burning sensation, or heartburn. If left untreated, GERD can eventually lead to lung damage, esophageal ulcers, and in some instances Barrett's esophagus, a condition that can eventually result in esophageal cancer.

Doctors most often look at GERD as the cause of asthma when the following happen:

• Asthma begins in adulthood.
• Asthma symptoms get worse after a meal, after exercise, at night, or after lying down.
• Asthma doesn't respond to the standard treatments.

Why do GERD and asthma coincide? One possible explanation is that the acid flow causes injury to the lining of the throat, airways, and lungs, making inhalation difficult and causing a persistent cough. Another possibility is that when acid enters the esophagus, a nerve reflex is triggered that causes the airways to narrow in order to prevent more acid from entering. This will cause shortness of breath. One study showed an increase in the rate of GERD in asthma patients treated with medications known as beta-adrenergic bronchodilators. However, further studies must be done before the relationship between GERD and these drugs can be understood.

If you have both asthma and GERD, it is important that you consistently take any asthma medications your doctor has prescribed and that you control your exposure to asthma triggers as much as possible.

This section includes information on controlling symptoms of GERD.