The Asthma-Heartburn Connection


Your heartburn and asthma symptoms may be connected. Find out how you may improve your asthma by treating acid reflux, also known as GERD or heartburn.

Your asthma isn't getting any better. You wheeze when you lie down. And you have terrible heartburn. You may have a condition called gastroesophageal reflux disease (or GERD). GERD is common in people with asthma. About 70 percent of people with asthma have it. And, it could be making your asthma symptoms tougher to treat.

What is GERD?
Your esophagus is the tube that carries food from the mouth to the stomach. Normally, the muscle at the end of the esophagus closes after food enters the stomach. In GERD, the muscle is loose, allowing stomach contents to back up, or reflux. Refluxed stomach contents are acidic and irritate the inside of the esophagus. This is experienced as heartburn.

What is the connection between asthma and GERD?
When stomach acid flows up the esophagus, it can irritate the airways. Also, when acid enters the esophagus, nerves are stimulated that can further narrow the airways. This can lead to wheezing and trouble breathing - an asthma attack. And some asthma medications, such as theophylline, can cause reflux.

Clues that you may have both asthma and GERD

  • Your asthma gets worse after you eat or after you exercise.
  • You have asthma symptoms at night after you lie down.
  • You have frequent coughs or hoarseness.
  • You have had pneumonia more than once.

How is GERD diagnosed?
Your doctor may start you on medications to treat GERD symptoms to see if it helps. In some cases, you may need tests, especially if medicine doesn't help or you have hoarseness, trouble swallowing or bleeding in the stomach or esophagus. Some of these tests are:

  • Endoscopy. A lighted flexible tube with a camera lens is passed down into the esophagus and stomach. The doctor can find erosions or ulcers.
  • Upper GI series. A set of x-rays is taken after you swallow barium, a white chalky drink. The barium coats the esophagus so it can be seen on x-rays. This test can show if you have swallowing problems or an ulcer.
  • Esophageal pH monitoring. An acid-sensing device attached to a thin, small tube is passed gently through your nose and down the esophagus. The device is left in for a full day or longer, recording the pH or amount of acid coming from the stomach. The data show when and how much you are refluxing.

What medications help?
Your doctor may recommend over-the-counter antacids or acid-blocking medications to help relieve the symptoms of GERD. If these don't help, your doctor may prescribe a stronger medicine. These drugs reduce heartburn thereby improving asthma symptoms, especially nighttime symptoms. Your doctor may also change your asthma medications if they are making GERD worse. Always take your asthma medications as directed.

What to do if you have asthma and GERD
In addition to taking your asthma and GERD medications as directed by your doctor:

  • Do not eat any meals 3 to 4 hours before going to bed.
  • Raise the head of your bed by 6 inches to use gravity to keep food in the stomach.
  • Do not overeat. Reduce portion size.
  • Limit your consumption of the following foods that can lead to reflux: Coffee, tea, colas, chocolate, peppermint, fatty foods and alcohol.
  • Limit intake of tomato and citrus fruits, which may increase stomach acidity.
  • Reach and maintain a healthy weight if you are overweight.
  • Wear looser fitting clothes, especially around the waist.
  • Quit smoking if you are a smoker. Smoking can lead to reflux.




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