Asthma and reflux.

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Thunderduck

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I'd be interested to hear from anyone who has both asthma and reflux.

Having been admitted to hospital yesterday and being told I'm likely to have CVA, and possibly reflux, I'd appreciate hearing about other's experiences with reflux.

I still have shortness of breath, chest and back pains today, but for the first time I'm beginning to feel some symptoms that could be reflux, some pain in upper abdomen and a strange rurabling/gurgling sensation.

For anyone who has both were you diagnosed with one then the other? Or separately. I'm a bit worried that if I have both that they'll diagnose only one and blame all symptoms on that without investigating the other.
 
I have both cough-varient asthma and reflux. My reflux symptom is a cough as well.

My asthma is triggered by environmental factors (cold, pollution, chemicals, etc...) and by the reflux.

The trick for me was finding treatments that work for both the asthma and the reflux and balancing them at the same time. I recommend that you find both a good Pulmonologist and Gastroenterologist. If you aren't comfortable with that route, a good ENT who specializes in asthma and LPR could also be helpful.

Reflux with symptoms in the upper airway and throat is called Laryngopharyngeal Reflux (LPR). You might want to do an internet search on this to get ideas for treatment.

I've had both the reflux and asthma for years. They were treated seperately with changes in treatment as the symptoms changed. A year ago, I ended up needing emergency asthma care. After that, I started seeing a new Pulmonologist. He did some testing and told me that I wouldn't be able to get my asthma under control until I got the reflux under control. That is when I went back to my GI doc. In the meantime, I had various treatments prescribed for the reflux and my asthma treatment was upped. In my case, it took a corabination of asthma meRAB and a double dose of PPI's for the reflux. My case is a bit extreme though. I ended up having surgery to correct the reflux. That was only after the treatments that worked for years stopped working. I did have things under control for about 6 years prior to this.

Some of the tests that I had that confirmed my asthma-reflux problem were: Modified Barium Swallow and Esophagram (these confirmed the reflux was coming up and irritating my lungs), 24 hr pH (confirmed the severity and frequency of reflux), Manometry (confirmed my LES was not working correctly), chest x-rays (ruled out other causes), EGD (verified the reflux hadn't caused esophageal damage yet), Pulmonary Lung Function testing (tested lung functioning and capacity). Also my history was important in the process as well. It was the Barium swallow that really confirmed that the reflux was coming up to my lungs.

Things to ask your doctors about: obtaining an emergency inhaler (such as Albuterol) for breathing emergencies, using a daily maintainence inhaler (such as Advair or Syrabicort), reflux medications (such as PPI's), diet recommendations.

To help with the reflux, there are also other things you can do. Prop the headboard on your bead up by about 6 inches. A couple bricks or some boarRAB can be used. I just bought some bed risers at a local bed and bath store. By doing this, you are using gravity to help keep the acid from coming up as easily. This isn't a cure, but may help some. Sleep on your left side also. Try to limit how much you are bending over and avoid clothes that are tight around your stomach. Every time you scrunch your stomach, it can push the acid up. Watch your diet. My GI doc has me avoiding: fatty, greasy and fried fooRAB, spicy fooRAB (including onions, garlic and peppers), tomatoes and tomato products, citrus fooRAB and drinks, caffeine and carbonated drinks, chocolate, alcohol and nicotine. Through trian and error, you may find other fooRAB that are triggers for you that you should avoid.
 
Thanks for the information. I am in the process of trial and error now. Between my gastro doc and pulmonologist, no one has recommended the tests that you have mentioned. As I mentinoned in my own "blurb"...I put myself back on Nexium. I don't have SOB though...hence, the diagnosis of Cough Variant Asthma.My next appt w/my pulmonologist is in a week or so. I'll mention the modified barium swallowing test and esophagram. He might recommend that I go back to my Gastro doc!
Please keep me updated on how things are going with your condition.
 
Hi Circus Flea,

As I posted above, my asthma symptom is a cough and my reflux symptom is a cough. Trying to identify what is triggering the cough can really be a challenge sometimes. That is why I have to work on treatments for both to get things under control. It can be really frustrating not being able to find a good answer. It can also wear you out with all the coughing. I also hated to make everyone around listen to my constant coughing.

The corabination that helped me for a while was: Allegra, Astelin, Flonase, Singulair, Advair 500/50, Prevacid 2x/day, Albuterol. Prednisone when the asthma flared also. I supplemented with Gaviscon as well.

Tessalon Perle didn't really do much for me. Cough syrups didn't help either. Although, Hydrocodone did give me some temporary relief by just allowing me to sleep for a bit. It is narcotic strength though so I didn't take it much.

Nexium created a really, really bad experience for me. With the range of PPI's, people have different one's that they found work. For me, single doses no longer worked either. Taking one dose in the am and one in the evening helped some.

I've had a recent asthma flare due to a sinus infection. Other than that, I have been reflux cough free for almost 5 months since my surgery. That has been a blessing. I've had some bad digestive issues though as a result of side effects from when I was on Nexium last June though so I'm still not back to "normal" yet.

I'm also still on all of the meRAB listed above too. The exception is that I'm now down to Advair 250/50 and no longer take the Faviscon.
 
Hello Thunderduck.
Thanks for your email. I'll look into all of this. Tried Albuterol and just about all the inhalers on the planet but they make me cough severely right after I inhaled them. I am now on Corabivent but hate to inhale it be/c I know I'll just cough more right away.
Sorry to ask this but what surgery did you have that helped you for 5 months?
You are right. The coughing is exhausting and can't be good for the spine.
Thanks again.
circus flea
 
One good thing about the coughing was the constant ab workout. The pulled muscles weren't fun though.

I had a Laproscopic Nissen Fundoplication. They made 6 small incisions across my stomach and navel. They then went in and pulled the top rounded part of my stomach (fundus) around my esophagus. They then stitched my stomach to itself. Now, every time my stomach contracts, it also contracts around my esophagus. It keeps food and acid from coming up. If you have a hiatal hernia, it is repaired as part of this procedure as well.

This surgery is an absolute last resort. I spent years trying other treatments first. The only reason I decided to persue the surgery was because the reflux was triggering my asthma so badly that I was having some severe attacks--chronic coughing and eventually some severe SOB. None of the medications or homeopathic treatments were having much effect in helping me get the asthma/reflux under control anymore. Although, I was able to get things under control at times over the years--once even after a 3 month coughing attack. Things just stopped working for me last year. I even had to take to carrying an epi-pen around just in case I had an asthma attack so severe that I needed some time to get emergency care. Surgery is not a decision to make lightly, but for me it truly came down the point that I couldn't breathe well anymore because of the constant acid aspiration and irritation to my lungs.

That said, the nissen seems to be more successful for those who have breathing related reflux symptoms than for some of the other reflux symptoms. My reflux related coughing was gone from the moment I woke up after surgery. I do still have the environmental asthma triggers, but I expected that and can keep it under control with my current asthma plan.

I continue to work closely with my PCP, ENT (allergist), Pulmonologist and Gastroenterologist so ensure things remain under control.

You haven't said how long you have had your symptoms. If it has been 3 months or less, you should have yourself tested for Pertussis (Whooping Cough). I ended up with it a few years ago. My symptoms were a horrible chronic cough exactly like the one I had with my acid/asthma flare. A nonstop cough so powerful I couldn't get a good breath. I ended up having two tests for it because the first came back inconclusive. If you were vaccinated when young, it can influence the results a bit. They have found in recent years that the vaccine doesn't protect into adulthood. Cases of Pertussis are on the rise. The typical asthma treatments weren't really effect for me with the Pertussis. I needed antibiotics and time. It is nicknamed the "100 days" cough.
 
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