A friend recently forwarded an article they saw online about the relationship between GERD and asthma and asked what I thought about it. In the article, the author talks about whether GERD causes asthma and states that while GERD can make the symptoms of asthma worse (and vice versa), GERD does not cause asthma. This highlights a common problem that comes up when discussing medical problems: confusing a symptom with a disease. Asthma is a symptom characterized by wheezing and breathing difficulty due to any narrowing of the air passages. The article talked about GERD and asthma as if it was one disease. It is not. Asthma is more correctly looked at as a symptom that results when the small air passages constrict (bronchoconstriction) for any reason.
This symptom (asthma) has many different causes:
- Bronchial or extrinsic allergic asthma – this is the common asthma of childhood. Children develop this when they are exposed to allergens (like pollens). It is an acute, treatable disease that most kids outgrow around the age of twenty.
- Bronchial asthma in adults – a more complicated asthma for which no real cause is found in most patients.
- Cardiac asthma – where heart failure can precipitate “asthma”.
- Asthma occurring in many other diseases: hypersensitivity pneumonitis, autoimmune diseases, carcinoid syndrome, certain drugs, etc.
- Exercise induced asthma
- Chronic asthma which is an end result of COPD
Now the situation becomes a little more clear. GERD can cause bronchoconstriction with symptoms that are identical to asthma of other types. This is likely caused by acid “fumes” that regurgitate into the throat, irritating the air passages and resulting in bronchoconstriction and “asthma.” Acid fumes enter the throat when reflux occurs and the liquid acidic gastric juices shoot up into the esophagus during a reflux episode. By understanding this, it becomes clear that GERD is a cause of asthma, but unrelated to any of the other causes of asthma.
Do you have asthma? Have you ever considered that your asthma symptoms might be related to your GERD? Have you noticed your asthma symptoms seem worse when your GERD flares up? We’d love to hear about your experience in the comments below.