Gastro-esophageal Reflux Disease in Bronchial Asthma –is There an Association?

Gastroesophageal reflux disease (GERD) is common in adult patients with asthma, with the reported prevalence ranging from 32 to 82%. Although typical GERD symptoms, such as heartburn and regurgitation, are more common in patients with asthma than in control populations, substantial acid reflux can be present without the typical reflux symptoms in patients with asthma. Acid reflux is a potential trigger of asthma and may also be a complicating factor in difficult-to-control asthma. There is also evidence that nocturnal GERD in particular may precipitate asthma symptoms. It is estimated that more than 75 percent of patients with asthma experience GERD. People with asthma are twice as likely to have GERD as those people who do not have asthma. Of those people with asthma, those who have a severe, chronic form that is resistant to treatment are most likely to also have GERD. Although studies have shown a relationship between asthma and GERD, the exact relationship is uncertain. GERD may worsen asthma symptoms, however asthma and some asthma medications may worsen GERD symptoms. On the other hand, treating GERD often helps to also relieve asthma symptoms, further suggesting a relationship between the two conditions. Although these two disorders often occur together, the relationship between GERD and asthma remains unclear. This article will review the prevalence, proposed pathophysiology, and treatment recommendations for persons with both asthma and GERD.