Leigh
12-02-2005, 09:33 PM
Children with asthma develop difficulty breathing because of irritated airways that result in shortness of breath, wheezing, and cough. A variety of factors, such as allergies, cold air, exercise, and respiratory infections can worsen this condition. Another potential trigger for asthma symptoms is acid reflux from the stomach or heartburn. Although many people have symptoms of heartburn, including burning sensation behind the breast bone, acid taste in the mouth, cough and sometimes nausea, otheres do not experience any symptoms, so called "silent reflux". The only symptom may be that their asthma is difficult to control with the usual medications.
Why does reflux aggravate asthma?
There are two possible reasons by which reflux can narrow the airways and worsen asthma. The first is that acid from the stomach can track up the esophagus, particularly when you lie down. Small amounts of acidic fluid can trickle down into the airways causing them to narrow and thereby create shortness of breath and wheezing. Alternatively, acid can reach the lower part of the esophagus and stimulate nerve endings. This can cause the smooth muscle in the airways to contract which narrows the breathing tubes.
How is reflux-induced asthma diagnosed?
Often the diagnosis is made based on a clinical history and improvement of symptoms with therapy. Symptoms of reflux-induced asthma include the following:
1. Asthma symptoms are worse after eating a high fat meal, coffee, chocolate, or alcohol.
2. Wheezing, shortness of breath, cough while experiencing heartburn.
3. Persistent cough, particularly if worse when lying down.
Remember, it is possible that the only symptom may be difficulty in controlling the asthma on the usual medications.
Specialized tests are available, such as the 24-hour esophageal pH monitoring, which measures the acid content in the esophagus. The asthma symptoms are matched with the esophageal acid events to confirm the diagnosis. It can also be used to monitor the effectiveness of reflux therapy.
What is the treatment?
Standard therapy for asthma such as inhaled corticosteroids and bronchodialators should be optimized. If symptoms of asthma persist despite optimal therapy, reflux should be considered as a possible aggravating factor.
Non-medical therapies include those found here on IRD:
http://www.infantrefluxdisease.com/help_infant_reflux.php (http://www.infantrefluxdisease.com/steps.htm)
Often, pediatric allergists will be able to control the asthma once the reflux is under control.
Why does reflux aggravate asthma?
There are two possible reasons by which reflux can narrow the airways and worsen asthma. The first is that acid from the stomach can track up the esophagus, particularly when you lie down. Small amounts of acidic fluid can trickle down into the airways causing them to narrow and thereby create shortness of breath and wheezing. Alternatively, acid can reach the lower part of the esophagus and stimulate nerve endings. This can cause the smooth muscle in the airways to contract which narrows the breathing tubes.
How is reflux-induced asthma diagnosed?
Often the diagnosis is made based on a clinical history and improvement of symptoms with therapy. Symptoms of reflux-induced asthma include the following:
1. Asthma symptoms are worse after eating a high fat meal, coffee, chocolate, or alcohol.
2. Wheezing, shortness of breath, cough while experiencing heartburn.
3. Persistent cough, particularly if worse when lying down.
Remember, it is possible that the only symptom may be difficulty in controlling the asthma on the usual medications.
Specialized tests are available, such as the 24-hour esophageal pH monitoring, which measures the acid content in the esophagus. The asthma symptoms are matched with the esophageal acid events to confirm the diagnosis. It can also be used to monitor the effectiveness of reflux therapy.
What is the treatment?
Standard therapy for asthma such as inhaled corticosteroids and bronchodialators should be optimized. If symptoms of asthma persist despite optimal therapy, reflux should be considered as a possible aggravating factor.
Non-medical therapies include those found here on IRD:
http://www.infantrefluxdisease.com/help_infant_reflux.php (http://www.infantrefluxdisease.com/steps.htm)
Often, pediatric allergists will be able to control the asthma once the reflux is under control.