The Relationship Between GERD and Asthma

Kristi M. Issac, BS, PharmD, AE-C

US Pharmacist. 2009;34(7):30-35.

Introduction

Asthma is a chronic airway disease characterized by airflow obstruction, bronchial hyperresponsiveness, and inflammation.^[1] There are many triggers and comorbid conditions that have been shown to increase asthma symptoms and/or precipitate asthma exacerbations. The Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma recognizes gastroesophageal reflux disease (GERD) as a comorbid condition of asthma and recommends medical management of GERD in appropriate patients.^[1]

The relationship between asthma and GERD has been discussed for many years. In 1892, Sir William Osler described an association: "severe paroxysms of asthma may be induced by overloading the stomach, or by taking certain articles of food."^[2] 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.

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Cite this: The Relationship Between GERD and Asthma - Medscape - Jul 01, 2009.

Table 1. Signs and Symptoms of GERD
Signs and Symptoms of GERD
Heartburn
Chest pain
Sore throat
Hoarseness
Frequent throat clearing
Globus hystericus ("lump in the throat" sensation)
Water Brash (regurgitation of excessive saliva)
Regurgitation of foods/liquids
Coughing
Loss of dental enamel

Source: Reference 31

Table 2. Proton Pump Inhibitors
Generic (Brand)	Standard Adult Dosing	Proposed Dosing for GERD-induced Asthma
Dexlansoprazole (Kapidex)	30 mg daily	NA
Esomeprazole (Nexium)	20 mg daily	20 mg twice daily
Lansoprazole (Prevacid)	15 mg daily	30 mg twice dice daily
Omeprazole (Prilosec)	20 mg daily	20 mg twice dice daily
Pantoprazole (Protonix)	40 mg daily	40 mg twice dice daily
Rabeprazole (Aciphex)	20 mg daily	20 mg twice dice daily

NA: not applicable. Source: Reference 31,38

Table 3. Foods and Medications That May Worsen GERD Symptoms
Foods	Medications
Alcoholic beverages	Anticholinergics
Carbonated beverages	Barbiturates
Citrus fruit drinks	Caffeine
Chocolate	Calcium channel blockers
Coffee	(e.g., dihydropyridine)
Fatty foods	Nicotine
Peppermint	Nitrates
Spicy foods	NSAIDs
Tomato products	Theophylline

NSAIDs: nonsteroidal anti-inflammatory drugs. Source: Reference 31

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The Relationship Between GERD and Asthma

Introduction

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Tables

Tables

References

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Authors and Disclosures

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