There's a definite correlation between acid reflux and asthma; doctors just aren't entirely sure exactly what it is. Acid reflux may make asthma symptoms worse, but asthma and some medications for it might also make acid reflux worse. What we do know is that treating acid reflux often relieves asthma symptoms, so it's always worth it to take a look at both sides of the reflux-asthma coin.
About Acid Reflux
Acid reflux, or gastroesophageal reflux (GER) is quite common in kids. It simply means that contents from the stomach, including acid, back up into the esophagus because the sphincter that's supposed to keep it down (called the LES) malfunctions or is not fully developed yet. One of the most common symptoms is spitting up. Regular acid reflux is usually nothing to worry about; most babies have some reflux during their first year of life, but then it typically subsides.
However, if symptoms continue past your child's first birthday or include abdominal pain, heartburn or shortness of breath, it could be more serious. What starts as the occasional episode of acid reflux can become GERD, or gastroesophageal reflux disease, which is more persistent and serious acid reflux.
About Asthma
Asthma is a chronic disease that affects breathing due to inflamed or sensitive airways that react to certain triggers. Those triggers include pollen, animal dander, cold air, cigarette smoke, certain smells and even strong emotions. When an asthma attack occurs, the airways swell and produce mucus while surrounding muscles tighten. This makes it difficult to breathe properly, and can result in shortness of breath, rapid breathing, chest tightness, coughing and wheezing.
The American Academy of Allergy, Asthma and Immunology says approximately 20 million Americans have asthma, and about 5,000 die from it each year.
Reflux Affecting Asthma
Sometimes you might think your child's main problem is asthma, but it really isn't; that's because GERD can disguise itself as other diseases. Acid reflux can irritate and damage the esophagus and make inhalation difficult, which can trigger many symptoms besides heartburn, including hoarseness, a chronic cough, and asthma-like symptoms; these are called "extra-esophageal manifestations."
It's also possible that acid in the esophagus triggers a nerve reflex, which makes the airways narrow to stop the acid from entering and at the same time causes shortness of breath. If the acid gets breathed into the lungs, it can make asthma symptoms even worse. In these cases, sometimes heartburn isn't even an issue, so you might not know your child has GERD, or even GER.
Doctors look at GERD as a possible cause of asthma if standard asthma treatment doesn't seem to help, if coughing is worse at night or if asthma symptoms get worse after eating, exercising or lying down. Treating the underlying symptoms of GER in these cases can also lessen the symptoms of asthma.
Asthma Affecting Reflux
Government clinical trial researchers say that 20 to 30 percent of Americans have acid reflux, but as much as 70 percent or more of asthma patients. Doctors at the Cleveland Clinic Foundation say asthma sufferers are twice as likely to have GERD as those who don't, and people with severe, chronic asthma that doesn't get better with treatment are even more likely to have GERD.
This may be because during an asthma attack, pressure in the chest changes, causing the LES to relax. As a result, acid travels back up into the esophagus, and can make asthma even worse by irritating the lungs. Also, some asthma medications, called beta-adrenergic bronchodilators, can cause the LES to relax.
Treatment
If your child has both asthma and acid reflux or GERD, it's important to prevent his exposure to any asthma triggers where possible. To keep the acid reflux under control, there are several easy lifestyle adjustments you can make.
Raise the head of your child's bed by about six to eight inches by putting blocks of wood underneath it. This lets gravity work to keep acid in the stomach; don't try to accomplish this with pillows, because it makes your child sleep in a bent position which puts pressure on the stomach and can worsen symptoms.
Feed your child small meals throughout the day, rather than a few large ones, and serve dinner three to four hours before bedtime so he has time to digest his food before lying down. Stick with natural, wholesome foods as much as possible, and encourage exercise; maintaining a healthy weight lessens symptoms of GER that are caused by the pressure of excess pounds around the middle. Certain foods can also trigger reflux, so limit fatty and spicy foods, acidic foods like tomato sauces and citrus, peppermint, chocolate and drinks with caffeine.
If none of this works, talk to your child's doctor about over-the-counter antacids or another medication for GERD.
