Allergens and heat can be a trigger for people living with asthma. Although an inhaler or pill works for most, some get no relief from these traditional treatments. According to Ohio-based news platform WKYC, it could be because their breathing problem is not caused by asthma but their stomach.
Take, for instance, the case of Michelle Skeldon. For more than a decade, her breathing symptoms worsened so she was prescribed stronger and stronger asthma medications. Skeldon recalls that just to walk up, perhaps five steps, was “extremely hard” for her because it was difficult to breathe. Then she came to a point that she was already on oxygen.
After she developed a dangerous case of bacterial pneumonia, her pulmonologist realized that she should be seeing a gastroenterologist instead. After extensive testing, the true cause of her breathing issues was revealed: gastroesophageal reflux disease or GERD.
Understanding gastroesophageal reflux disease
GERD can be mistaken for asthma and often worsens. Some acid reflux is normal but when the contents of the stomach travel up the esophagus and into the back of the throat, it becomes an issue in the lungs. This is because the liquid flows into the airways and enters the lungs. Then, it will lead to a slew of symptoms, such as hoarseness, cough, shortness of breath, and pneumonia.
Lifestyle changes and medication are often advised by doctors but in Skeldon’s case, she had to undergo surgery to prevent the stomach contents from reaching her lungs. She details that as soon as she had the surgery done, the coughing stopped. “It was totally a different world,” she said, describing the healing experience as “amazing.”
Why GERD often goes unchecked
According to experts, GERD often goes unchecked because the reflux is not always acidic. This means that it doesn’t cause indigestion or heartburn that we associate it with. Yet, if GERD is not treated, it can have a dangerous long-term effect, like an increased risk of permanent lung damage or esophageal cancer.
Meanwhile, Healthline says that difficulty breathing is one of the more frightening symptoms of acid reflux and the chronic form of such a condition called GERD. It can be linked with breathing difficulties, like aspiration and bronchospasm. Sometimes, these difficulties can lead to life-threatening respiratory complications.
The American health platform also shares that shortness of breath can occur in GERD alone or conjunction with asthma. The two conditions are usually linked. More than three-quarters of people with asthma also experience GERD and those diagnosed with asthma are twice as likely as those without asthma to have GERD.
GERD could also worsen asthma symptoms and vice versa. But the good thing is that treating GERD likewise often helps improve asthma symptoms, such as shortness of breath.
Primary treatment of GERD
Typically, the primary treatment of GERD is simple lifestyle changes. Fatty foods, spicy foods, alcohol, tomato juice, coffee, and caffeinated drinks should be avoided. Foods that are rich in fiber, whole grains, and red meat should also be reserved for the earlier parts of the day as they are more difficult to digest in the evening and could stay in the stomach beyond bedtime. Furthermore, alcohol intake and smoking should be minimized. Breathing techniques and mindfulness, on the other hand, can help in controlling excessive stress that may also be a contributing factor to GERD.
Changes in eating habits, like earlier evening meals and eating smaller portions of food, are also recommended. The elevation of the upper body and the head while sleeping can also improve the symptoms. Doctors may likewise prescribe medications to neutralize acid reflux and preventing the formation of excess acid in the stomach.
GERD Prevalence in global populations
A review study, which appeared in the journal Gut, shares the GERD prevalence in global populations as follows: 18 to 28% in North America, 9 to 26% in Europe, 3 to 8% in East Asia, 9 to 33% in the Middle East, 12% in Australia, and 23% in South America.
Because GERD is a chronic disease rather than an illness, it also causes significant economic impact due to the expense of the long-term management of the disease. Direct costs linked with the disease include costs of prescription and over-the-counter medications, hospital and physician office visits, surgical costs, and costs of possible complications, such as esophageal adenocarcinoma, that may result from the disease. This is according to G. Richard Locke III, M.D, an Associate Professor of Medicine at Mayo Medical School.
In the World Gastroenterology Organisation’s Handbook on Heartburn, it shows that the prevalence of GERD in Olmsted, the USA alone is 19.8 from a total of 1,511 subjects surveyed. The prevalence was obtained by determining the symptom scores. Participants were asked questions, like how often they have a burning feeling behind their breastbone (heartburn), how often they have stomach contents (food or liquid) moving upwards to their throat or mouth (regurgitation), how often they have a pain in the center of their upper stomach, how often they have nausea, how often they have difficulty getting a good night’s sleep because of their heartburn and/or regurgitation, and how often they took additional medication for their condition than what their physician told they should take.
Other places included in the study are Moscow (23.6 GERD prevalence), Turkey (22.8), Argentina (23), Eastern Iran (25.7), Philadelphia (26.2), Madrid (8.5), Spain (9.8), and China (2.5). In Italy, the share of individuals affected by GERD increased from 6.2% in 2007 to 17.9% in 2017, reports Statista.
Acid reflux and anxiety
Several studies have also found that anxiety seems to increase symptoms associated with GERD, particularly in women. Some experts believe that the cholecystokinin, a brain chemical linked to both gastrointestinal disorders and panic disorders, may play a role in the prevalence of GERD in individuals with anxiety disorders. Not to mention there are theories, which show that anxiety can increase stomach acid, slow digestion, or increase muscle tension that puts pressure on the stomach. Another contributing factor is that anxious people tend to engage in behaviors that could trigger or worsen their acid reflux, like eating fried or fatty foods, drinking alcohol, and smoking.
Considering as a whole, if you suspect that you have GERD or difficulty breathing, be sure to ask for a proper diagnosis and treatment plan.