Stuff I didn't know about GERD and Asthma

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janewhite1

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I'm sure most of you folks are wise to all of this already, but I'll put it out there.

GERD triggers Asthma. Acid comes up into throat, acid tickles lungs, this is bad. This I knew.

I didn't realize quite how much asthma can trigger GERD! Directly, through coughing or straining to breathe, but also indirectly, through medicines.

Beta-agonists, bronchiodilators, stuff like Salmeterol and Albuterol? Not only does it relax the smooth muscles of the respiratory passages, it can also relax the smooth muscles of the esophagus, including the lower esophageal sphincter, that lovely valve that's supposed to keep stomach acid down in the stomach. When it gets lazy, we get heartburn.

Antihistamines can have the same effect, as can oral steroiRAB and many other medicines. There's fairly good evidence that inhaled steroiRAB do not have any digestive side effects. (Yay!)

This might explain why I went through yesterday tasting stomach acid nonstop, regardless of what or when I'd last eaten...
 
In my case, I always know long before my Asthma acts up that I have encountered an offending allergen/irritant because of indigestion. I NEVER suffer from indigestion unless I am going to have problems with my Asthma.

Fortunately, that gives me time to take corrective action.
 
GERD, acid reflux, etc all can mimic asthma as well. I have a friend who was treated for asthma for several months with no relief. I kept telling her to see a pulmonologist or allergist but she kept going to her PCP. Finally, her PCP decided she just couldn't help her and sent her - of all people - my pulmononary clinic. She saw my doctor and found she had no allergies, did not have asthma but has acid reflux. After 2 weeks on the proper meRAB, diet change, etc she was feeling fine. Amazing what a correct dx can do for you!
 
I share many of the same problems as Mountain Reader. I have cough variant asthma, gerd, and vocal cord dysphonia. It's often difficult to figure what's causing my triggers, so of course, they treat for everything. I also have some other issues that complicate things (don't we all?) so I guess we do the best we can.
Actually I am in much better shape than I was a couple of years ago.

BTW, does any one else take Zyflo CR? It's a leukotrine inhibitor and I was switched to this from singulair. However my pharmacy tells me that I am the only patient who receives this med. I guess it must be new, but it does seem to work.
 
I've been on Zyflo CR for about 2 years. It's actually not that new. Zyflo was patented a couple of years before Singulair but required 4x daily dosing so it never really caught on. The CR formulation is relatively new, it has a slightly different mechanism of action than Singulair, and can cause liver problems in some people (rarely).

I have had doctors tell me that "you must have that name wrong" when I give them my list of medications and have to go look it up.
 
I'm an extreme example of this. :dizzy: It's a viscious cycle between GERD and Asthma. The acid irritating the lungs and throat causing the cough which squeezes the stomach pushing the acid up and starting it over again. It is a chicken and egg thing. Sometimes something triggers the asthma which starts the cycle again. Add allergies into the mix and things get worse.

I have both and was able to keep them under control until my treatments just stopped working.

My primary symptoms for both GERD and Asthma was a chronic cough and difficulty getting a good breath. When I hit my worst, I couldn't tell which was flaring. For almost 5 months, I had extremely poor quality of life and couldn't get a good breath in between the severe coughing. At one point I was on a very restricted diet and TWELVE medications. I hit the point I needed emergency treatment for an asthma attack that liiterally took my breath away. It was exhausing both mentally, physically and to my pocketbook. I ended up bouncing between my PCP and THREE specialists (Pulmonologist, Gastroenterologist and ENT/Allergist). Finally my Pulmonologist had me go for a Barium Swallow/Esophagram that showed I had reflux irritating my lungs and I was actually aspirating some acid. I ended up having repeat pH testing, Manometry and Endoscopy that I had just had a couple years before. Despite losing weight, being on PPI's twice a day and regular Gaviscon, eating a restricted diet, taking Singulair, Advair 500/50 and Albuterol, I couldn't get things under control. My testing showed that my reflux had gone from severe to extreme over the matter of a couple years even while I was on the twice per day PPI's. My LES just wasn't functioning well at all and had gotten much worse from my testing a couple years before. How frustrating. I eventually opted for GERD surgery--extreme, but necessary. It worked well for me, but I still take Kapidex/Dexilant 60 mg and still watch my diet. My Pulmonologist said I would have ended up in the hospital fighting for my life if I hadn't had the surgery when I did. Of course he didn't tell me that until after the surgery. ;)

BTW, it you have ever had a severe chronic cough, you know there are other side effects that eventually follow. Very unpleasant. If it comes to that point for you, I'll share, otherwise, it is better left unsaid. If you've ever had Pertussis you'd understand as well.

Titchou is right, the GERD can mimic asthma. I already had environmental and allergic asthma triggers. That is why it was so difficult to identify what was happening for me. I typically aggressively treated both at the same time. I was able to keep things under control for 6 years with that approach.

Ironically, my cough returned this last winter. I was sure it was just asthma because of my surgery, but after months of the cough, they actually sent me to have GERD testing for a 3rd time to confirm that the reflux wasn't causing the cough. Even the doctors can't tell what the trigger is except through trial and error.
 
I am extremely sensitive to almost everything in this world that either moves, or doesn't move. Pollens....... Irritants....... Odors........ Indoor Irritants...... Outdoor Irritants......... FooRAB....... Drinks........ and on and on and on.

I am like the canary in the mine. If there is anything asthma causative brought into my home, or environment, or surroundings, there are a few things that happen to me, besides the labored breathing, that tip me off that something has run amuck with my Immune System/Asthma/Allergies.

One of the biggest clues that I get is the indigestion. I also feel very warm, get tingling fingers and hanRAB, start feeling tired; and then I know that I could be in trouble. One of the very first symptoms is the indigestion.

The Flovent prevents me from going into a full fledged Asthma attack, but it is the labored breathing, that can last for hours or days, that really, really bugs the heck out of me. I hate the labored breathing component of Asthma.

Anyways...... this is an interesting subject, and is kinda like the question of which came first, the chicken or the egg. In other worRAB, does Asthma cause GERD, or does GERD cause Asthma, or are both true?? And.... how much of the answer is individual in nature, and can't be applied in general?

In my case, my Asthma brings on the indigestion. The worse the indigestion gets, the quicker that I have to remove the offending irritant, or I am really in jeopardy for having long lasting, hours of problems.

Everyone is different and reacts differently to different irritants and triggers.

Just thought that I would add my 3 cents to this interesting thread.
 
Good luck on the Zyflo-my asthma doc tried me on it because I do well with Singulair. The side effects are worse than the asthma! After 2 doses I felt like I'd been hit by a train. Needless to say, I quit. The other down side-it coses $605/month! I already spend over $2000 between DH and so another $600 just isn't an option.

Good luck!
Lynn
 
MountainReader: I think my current issue is that my LES is absurdly sensitive to drugs. My digestive system was in fine shape for months with no acid medicines at all, then this started.

My own symptoms tipped me off to the whole asthma medicines cause reflux thing, then I came across the articles documenting it. SounRAB like that might have been part of the problem for you, too, if you were inhaling a LOT of albuterol.

When I start having breathing problems, my chest hurts, it feels tight, and I pant and sigh and feel tired. I take a hit of albuterol, and the breathing difficulties go away, but the discomfort in my chest actually gets worse soon after. Pain is better than asphyxia, but I try not to use the inhaler unless it's clearly necessary.
 
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