Gastroesophageal Reflux Disease (GERD) is the backward flow of acid from the stomach into the esophagus (food tube connecting the mouth to the stomach).
Symptoms and Triggers
GERD is most likely to occur at night while lying down in bed or soon after eating. Local irritation in the esophagus can cause symptoms that vary from indigestion-like chest discomfort (heartburn) and abdominal pain to coughing and wheezing. If the gastric acid reaches the back of the throat, it may cause a bitter taste in the mouth and/or aspiration of the gastric acid into the lungs. The acid can cause throat irritation, post nasal drip and hoarseness as well as recurrent cough, chest congestion and lung inflammation leading to asthma and/or bronchitis/pneumonia. GERD can cause respiratory symptoms in two ways:
Factors that increase the chance of GERD:
There are a number of simple measures you can perform to reduce or eliminate symptoms of GERD. Medications can also help, but they are not as effective without the following simple measures:
|H2 Blockers||Proton Pump Inhibitors (PPI)|
|Axid® (nizatidine)||Aciphex® (rabeprazole)|
|Pepcid® (famotidine)||Nexium® (esomeprazole)|
|Tagamet® (cimetidine)||Prevacid® (lansoprazole)|
|Zantac® (ranitidine)||Prilosec® (omeprazole)|
Certain medications may cause gastrointestinal upset and may worsen heartburn symptoms. Among these are two medications which are commonly used for the treatment of asthma: oral corticosteroids (prednisone and Medrol®) and theophylline (Theo-24®, Uniphyl® and others). Your asthma specialists should take into consideration the presence of GERD when prescribing asthma medications. Blood levels of theophylline are closely followed as elevated theophylline levels in the blood are associated with more frequent occurrences of nausea, stomach upset and vomiting.
After careful individual consideration of your symptoms, your physicians may determine that your condition requires the use of theophylline and/or oral corticosteroids to more effectively control your breathing problem. In addition, your physician may use medications to reduce or prevent the production of stomach acid (H2 blocker or proton pump inhibitor), especially when using theophyllines and oral corticosteroids. In extreme cases of GERD that do not respond to medications, surgical procedures may be an alternative treatment.