Gibson, P.G., Henry, R. and Coughlan, J.J., 2003. Gastro‐oesophageal reflux treatment for asthma in adults and children. The Cochrane Library.
These recent, large clinical trials have focused on the treatment of acid reflux. A theory has been put forth that alkali GERD may worsen asthma control; however, to date, this theory has been largely unproven, as only a few small studies have evaluated this type of GERD.
These are conditions where there is weakness of the tracheal and bronchial walls due to loss of integrity of cartilage and hypotonia of myoelastic elements. Tracheobronchomalacia is to be suspected when there is presence of monophonic wheeze that persists for longer than 10-14 days after every respiratory tract infection, wheezing that is worse when the child is awake and active and minimal when asleep, and when there is associated stridor .
Additionally, eating smaller meals, not laying down for at least 3 minutes after eating, and raising the head of the bed are examples of the ‘how’ that might decrease reflux symptoms. You experience asthma symptoms after eating foods that make reflux worse, such as a high-fat meal, alcohol, chocolate, or caffeine. Reflux can be one of the triggers in the pathophysiology of asthma that leads to more asthma symptoms or even trigger an asthma attack. There are growing concerns of side effects of proton pump inhibitor therapy, including a potential increase in upper respiratory infections or pneumonias as well as fractures in children.
Which foods to avoid for COPD? Learn more about how diet can affect lung health. Symptoms of COPD include shortness of breath, wheezing, and chronic cough. Treatment of COPD include GOLD guidelines, smoking cessation, medications, and surgery.
What You Can Do If You Have Asthma and Reflux
Nemours Children’s Health System is one of the nation’s largest integrated non-profit pediatric health systems that focuses on prevention and education, medical research, academics and health advocacy to improve the lives of children and families everywhere. Nemours owns and operates two free-standing children’s hospitals and extensive community networks of specialty, urgent and primary care locations, as well as online video doctor care, throughout the Delaware Valley and Florida. Everyone has experienced gastroesophageal reflux. It happens when you burp, have an acid taste in your mouth or have heartburn. However, if these symptoms interfere with your daily life it is time to see your physician.
and are important causes of insomnia and sleep deprivation among patients with asthma. In fact, sleep disturbances in patients with asthma usually mean that there is inadequate control of the asthma and should prompt a visit to the doctor to re-evaluate the treatment being used for the asthma. Children with eosinophilic esophagitis often have abdominal pain, difficulty swallowing, vomiting, failure to thrive and weight loss. Just a few years ago, incidents of the disease were rare.
It is also important to assess whether certain asthma medications may be worsening GERD. Asthma medications that could increase reflux include theophyllines and oral steroids, and should be used only if there are no other alternatives. Alcohol consumption in excess and caffeine can also predispose to acid reflux. Sleeping on several pillows with the upper body propped up to let gravity keep the fluid down may help.
The presence of persistent unilateral wheezing should always prompt the investigation of focal airway obstruction. Stridor is a sign of severe laryngeal or tracheal obstruction. Patients may also present with other nonspecific symptoms such as exertional dyspnea and positional wheezing. With an anatomically fixed obstruction, shortness of breath and wheezing are typically unresponsive to bronchodilators; failure of a patient to improve with these measures should prompt the physician to consider the presence of CAO . The evaluation of these subjects should always begin with spirometry, and it is particularly important to evaluate the shape of the flow-volume loop, in addition to the FEV1, FVC, and FEV1/FVC ratio, lung volumes and diffusion capacity.
Extrathoracic mimickers of asthma
Spirometry. This is a simple breathing test that measures how much and how fast you can blow air out of your lungs. Airway obstruction due to asthma or COPD is quickly revealed. Spirometry can be done before and after you inhale the asthma drug albuterol, a bronchodilator.
The most commonly used category is the proton pump inhibiter (PPI) and includes such medications as omeprazole (Prilosec), lansoprazole (Prevacid), pantoproazole (Protonix), and esomeprazole (Nexium). PPI drugs decrease stomach acid production. The next category is prokinetics and includes bethanechol (Urecholine) and metoclopramide (Reglan).
For most who suffer from both conditions, asthma can be controlled with the usual asthma therapies along with treatment of GERD. If these simple measures don’t work, then more extensive evaluation and treatment may be needed.