Heartburn

Can someone please tell me why you suffer alot of heartburn with asthma? I have just been back to my gp after countless sleepless nights of chronic heartburn she said my gallbladder was inflamed. I seem to read alot of posts talking about heartburn is it just coinsidance or do we get it from inhalers or tablets? thanks for your time xxx

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Hi Kerry-anne,

Sorry to hear that you are suffering at the moment - I'm glad you've been to your GP to get the official verdict on what's going on. Gallbladder inflammation and heartburn are slightly different conditions.

Heartburn occurs due to Gastro-Oesophageal Reflux Disease (GORD/GERD). This occurs when acid from the stomach manages to find its way through the valve between the stomach and the oesophagus (gullet) and rise up the gullet, causing inflammation and pain. The gallbladder is a small organ which sits inbetween the liver and the small bowel and helps with digestion of food in the small bowel - it can become inflammed for all sorts of reasons, sometimes due to the formation of gallstones or due to infection.

Gallbladder disease is not particularly linked with asthma, as far as I know (although I am willing to be corrected if anyone knows differently!). Heartburn, however, has a quite complex two-way interaction with asthma, and, as you have noticed, many of us suffer from it.

The drugs we take for asthma can contribute to GORD and to the more general 'indigestion' type symptoms that many of us get. Steroids, particularly if taken in combination with other irritant drugs, can irritate the stomach lining and cause pain. Drugs that cause bronchodilation of the airways, such as salbutamol, terbutaline, salmeterol, formoterol and theophylline/aminophylline, can also, if taken in large enough doses, cause dilation of the valve between the stomach and the gullet. This obviously can make it easier for the acidic stomach contents to rise up from the stomach into the gullet.

GORD can also cause worsening of asthma symptoms, as acid that comes up the gullet may spill over slightly into the lungs and irritate them, causing bronchospasm and wheeze. Rarely, GORD can be the main cause of severe asthma - part of the investigation of severe asthma often involves testing for GORD.

The treatment of GORD includes general measures like eating a good diet, losing weight if overweight, and sleeping with the head of the bed raised or propped up on pillows. Specific treatments that can be prescribed include Proton Pump Inhibitors (PPIs) such as omeprazole and lansoprazole which reduce acid secretion in the stomach. Occasionally in severe cases, surgery can be done to tighten the valve in between the stomach and gullet.

There are few specific treatments for gallbladder inflammation, apart from antibiotics if infection is causing the inflammation. If gallstones are the problem (diagnosed on an ultrasound scan) then surgery may be recommended to remove the gallbladder and the stones - this is usually done by keyhole surgery and is usually well tolerated.

Did your GP suggest any further tests or treatment, or is it just a case of waiting to see what happens? I hope things settle for you soon.

Hope this helps

Em H

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Hi Emily thanks for such a quick reply. When I saw my dr she said I have to take lansorazole (excuse spelling). She also said there was a letter from the hospital saying I would benifit from a camera to have a look what is going on in my stomache. As it was a emergency appointment we did not really go into it but I have to go back and see her in a week so think I will ask to get refered to reflux dr. Hope that makes sense again many thanks.

Take care

kerry-anne

xx