Medical News Today: What causes acid reflux and shortness of breath?

Acid reflux occurs when acid leaks up from the stomach back up into the esophagus. When this happens, the acid can irritate the airways, causing them to swell. This can result in breathing difficulties.

The link between GERD and asthma

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Researchers have also identified a link between GERD and asthma. A 2019 study suggested a bidirectional relationship between GERD and asthma. This means that people with GERD may be more likely to have asthma, and people with asthma may be more likely to experience GERD.

In fact, a 2015 study estimates that up to 89% of people with asthma also experience GERD symptoms. The reason for this may be due to how acid interacts with the airways. Acid in the esophagus sends a warning signal to the brain, which triggers the airways to contract. This, in turn, triggers asthma symptoms.

In cases of GERD-related asthma, treating the symptoms of GERD may help alleviate the symptoms of asthma.

As a 2016 review notes, asthma may also trigger GERD. During an asthma attack, the airways tighten, causing pressure in the esophagus. This increased pressure could encourage acid to leak into the esophagus.

Sometimes, it may be difficult to tell whether a person’s symptoms are the result of asthma or GERD. For instance, a 2015 case study notes that typical GERD symptoms, such as burping and shortness of breath, may sometimes be signs of asthma. The authors of this study emphasize the importance of a thorough diagnosis in each case.

A person experiencing acid reflux or GERD will likely experience additional symptoms, such as:

People with GERD-related asthma symptoms may also notice that their breathing difficulties flare up at certain times. Often, this occurs during sleep or after eating a large meal.

Untreated or unmanaged GERD can lead to numerous health complications. Some examples include:

Tooth decay

GERD symptoms may cause partially digested food and acid to leak back up into the mouth. The acid can come into contact with the teeth, increasing the risk of tooth decay.

Esophageal ulcers

Sometimes, acid can wear through the lining of the esophagus, causing ulcers.

Esophageal ulcers may cause the person to spit up blood or pass blood in their stool.

Respiratory complications

Accidental inhalation of stomach acid into the airways (called aspiration) can worsen respiratory conditions such as asthma or lead to pneumonia.

Throat and voice problems

Long-term exposure to stomach acid may lead to a sore throat or changes in a person’s voice.

Esophageal inflammation

Acid that backs up into the esophagus may cause inflammation of the esophagus. Doctors refer to this as “esophagitis.”

Esophagitis can be painful and may lead to scarring of the esophagus.

Stricture

Over time, chronic inflammation of the esophagus can lead to a build-up of scar tissue and narrowing of the esophagus called a “stricture.”

A person who has a stricture may experience pain or difficulty when swallowing.

Barrett’s esophagus

People who experience persistent GERD are at increased risk of developing Barrett’s esophagus. This is where the tissue in the esophagus begins to resemble tissue in the small intestine.

Some people with Barrett’s esophagus will go on to develop esophageal cancer.

Esophageal cancer

People who experience severe and persistent GERD are at increased risk of developing esophageal cancer.

Treatment for esophageal cancer is much more effective If a person begins treatment in the earlier stages of the disease.

Symptoms of esophageal cancer include:

• chest pain
• chronic cough
• difficulty swallowing (which may progress from difficulty swallowing solids to liquids)
• weight loss
• bleeding into the esophagus
• bone pain (if the cancer has spread to bones)
• hoarseness

Lifestyle and dietary changes are typically the first line treatment for GERD symptoms, such as acid reflux and shortness of breath. If these treatment options are not effective, a doctor may prescribe medication to manage GERD symptoms.

Lifestyle changes

Some lifestyle changes that may alleviate GERD symptoms include:

• achieving and maintaining a healthy weight
• quitting smoking
• avoiding laying down within 3 or 4 hours of eating a full meal
• elevating the head slightly while sleeping, which may help to reduce night-time acid reflux
• sleeping in a comfortable position that keeps the body aligned
• avoiding tight clothing, belts, or accessories that put pressure on the abdomen

Dietary changes

The following dietary changes may also help to alleviate GERD symptoms:

• identifying and avoiding personal food triggers for GERD, such as citrus, or other acidic foods
• reducing alcohol consumption or avoiding alcohol completely
• eating smaller, more frequent meals, instead of large meals
• avoiding eating near bedtime

Medical treatment

The following drugs may help to suppress acid reflux and prevent complications from GERD:

• over-the-counter (OTC) or prescription-strength antacids
• proton pump inhibitors
• H2 receptor blockers

A one-off or occasional bout of acid reflux and shortness of breath may not be cause for concern. If a person can keep the symptoms at bay using OTC medications, there is generally no need to see a doctor.

However, anyone experiencing persistent acid reflux or GERD symptoms should see a doctor for a full diagnosis. A doctor may carry out diagnostic tests to determine the cause of GERD and to identify any possible complications. A doctor may also prescribe medication to help manage GERD symptoms.

A one-off or occasional bout of acid reflux and shortness of breath is rarely cause for concern. However, anyone who frequently experiences this combination of symptoms may have gastroesophageal reflux disease (GERD) or asthma. They should see a doctor for a full diagnosis.

People who experience GERD symptoms may benefit from certain lifestyle and dietary changes. Some people may require medication. Early treatment may help to prevent complications from GERD.