Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common condition in which acidic stomach contents flow back into the esophagus, causing symptoms like heartburn and, in children, vomiting. Asthma is a chronic respiratory condition of the lungs, in which inflammation causes cough and wheezing. There is a correlation between the incidence of acid reflux and the occurrence of symptoms in children with asthma.
Causes
Acid reflux results from weakness of your lower esophageal sphincter, the band of muscle that surrounds the portion of the esophagus that connects to your stomach. According to the National Digestive Diseases Information Clearinghouse, the lower esophageal sphincter acts like a valve between the stomach and the esophagus, preventing stomach contents from flowing the wrong way. In children with GERD, the stomach contents can reach the upper airway and cause inflammation, and cause or worsen asthma symptoms.
Effects
In adults, the most prominent symptom of acid reflux is heartburn. Children often do not report heartburn as their primary symptom of GERD. Rather, they will experience vomiting and difficulty swallowing. Children with asthma can exhibit dry cough and wheezing, the high-pitched noise that air makes as it moves thorough narrowed and inflamed airways, as symptoms of both asthma and GERD.
Considerations
Lifestyle changes can help decrease the risk of asthma and GERD in children. Avoidance of cigarette smoke can help prevent asthma attacks. According to the Nemours Foundation, children with GERD and asthma should avoid foods that increase the production of acid in their stomachs, like citrus fruits, chocolate and caffeinated drinks; or ones that cause allergic reactions, like peanuts in children with nut allergies, which can lead to an asthma attack.
Diagnosis
Children with severe asthma and reflux may need diagnostic studies to determine the degree of GERD, especially if the symptoms persist despite proper treatment. For example, a barium swallow radiograph can detect anatomic abnormalities in the esophagus and stomach that may be contributing to reflux. An endoscopy can be used to visualize the esophageal tissue and verify the presence of irritation caused by acid reflux.
Treatment
Treatment of GERD can decrease the incidence of asthma attacks. Medications can be used if dietary changes and lifestyle modifications do not decrease the incidence of GERD. These include over-the-counter antacids; H2 blockers like ranitidine, which decreases acid production; and proton-pump inhibitors, which are more effective and longer-acting that H2 blockers. The treatments for asthma attacks include steroids, to reduce the inflammation surrounding the airways; and bronchodilators, like albuterol, which work by relaxing the muscles surrounding the airways and help them open up to improve air exchange.
