October 10, 2025 | Black & Kletz Allergy
Individuals with asthma probably are unaware of the association between asthma and acid reflux (GERD). It is estimated that approximately 75% of asthmatics have GERD of some degree. GERD or acid reflux occurs when there is a backflow of stomach contents into the esophagus (i.e., swallowing tube). In other words, the stomach contents travel in the wrong direction and enter the esophagus, instead of the small intestines. People with GERD often complain of “heartburn,” which in reality is a burning sensation in the chest and/or throat usually in conjunction with a sour or bitter taste in the mouth. In addition, some individuals may experience other symptoms which may include sore throat, burping, abdominal bloating, nausea, wheezing, coughing, and/or the sensation that something is caught in one’s throat. It is the wheezing and coughing symptoms that cam mimic asthma in individuals without asthma. In true asthmatics, acid reflux may actually worsen their asthma symptoms, not just mimic them.
In patients with asthma, the typical asthma symptoms of chest tightness, coughing, wheezing, and/or shortness of breath may be aggravated if the underlying acid reflux is not treated appropriately. The first way this may occur is via small amounts of acid irritating the airways (similar to a chemical burn) which may in turn cause asthma symptoms. The second method may involve the triggering of a reflex in the airways to become narrower in order to prevent more acid from entering the airways. It is this narrowing of the airways that causes an individual with asthma to cough, wheeze, cough, experience chest tightness and/or feel short of breath.
In addition to the 2 methods above, some asthma medications may decrease the lower esophageal sphincter pressure thus relaxing this muscle which in turn will increase the severity of GERD or acid reflux. Asthma medications in the bronchodilator family such as albuterol (i.e., Proventil, ProAir, Ventolin, AccuNeb), terbutaline (i.e., Brethaire, Brethine), vilanterol, ipatroprium (i.e., Atrovent), salmeterol (i.e., Serevent), formoterol, (i.e., Foradil), levalbuterol (i.e., Xopenex), and Tiotropium (i.e., Spiriva) fall into this category. There are also asthma medications that are combinations of two or more medications, one of which is a bronchodilator, which can therefore increase acid reflux disease. The names of some of these medications include Advair, Dulera, Breo Ellipta, Symbicort, Combivent, AIRSUPRA, Trelegy, and DuoNeb. Theophylline (i.e., Theo-Dur, Uniphyl, Slo-Bid, Theo-24), an older but still useful oral bronchodilator asthma medication, has also been associated with an increase in GERD in patients by causing the relaxation of the lower esophageal sphincter as well. Interestingly, the chemical structure of theophylline is similar to that of caffeine which is another trigger of GERD.
It is a double edge sword because not only can acid reflux exacerbate one’s asthma, but asthma can also make one’s acid reflux worse. In addition to asthma making one’s acid reflux worse, there are several risk factors that may contribute to GERD and some of them may include obesity, alcohol use, diabetes mellitus, pregnancy, smoking, connective tissue diseases (e.g., systemic sclerosis or scleroderma), eating large meals, eating before bed, hiatal hernia, certain medications [e.g., aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), oral corticosteroids, bronchodilators, calcium channel blockers], and/or certain foods [e.g., caffeine, spicy foods, .garlic, onions, fatty foods, acidic foods (soda, citrus fruits, tomatoes)].
The diagnosis of GERD can be made by performing a comprehensive history from the patient along with observing relief when taking anti-reflux medications such as antacids and/or acid-blocking medications. If there is no improvement in acid reflux symptoms, there are several procedures that can be performed in order to help establish the diagnosis of acid reflux disease. Some of these procedures include upper endoscopy with or without a biopsy, barium swallow, pH monitoring (checks the acidity in the stomach), and esophageal manometry (checks the function of the lower esophageal sphincter and esophagus).
The treatment of GERD is directed at reducing the risk factors mentioned above as well as prescribing acid-blocking medications and antacids. By treating the underlying GERD in patients who are asthmatic with associated GERD, the symptoms of asthma (i.e., chest tightness, coughing, wheezing, and shortness of breath) may also be reduced.
The board certified allergy doctors at Black & Kletz Allergy have been diagnosing and treating asthma for more than 50 years. We treat both pediatric and adult and patients. Black & Kletz Allergy has offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. All 3 of our offices have on-site parking. For further convenience, our Washington, DC and McLean, VA offices are Metro accessible. Our McLean office location offers a complementary shuttle that runs between our office and the Spring Hill metro station on the silver line. For an appointment, please call our office or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day. If you suffer from asthma or allergies, we are here to help relieve or hopefully end these undesirable symptoms that have been so bothersome, so that you can enjoy a better quality of life. Black & Kletz Allergy is dedicated to providing the highest quality allergy care in a calm, compassionate, and professional environment.
