Asthma and GERD: my asthma was awful... - Asthma UK communi...

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Asthma and GERD

StephenB1982 profile image

my asthma was awful for no reason for about 2 years, I couldn’t hold a conversation, I was coughing so much my head would feel like it was going to crack open and I was convinced I had a brain tumour

I went to the doctors and as usual they took my peak flow reading - I blew a 550 which he my average and they told me my problem wasn’t asthma….but that was it!! No further investigation, no questioning about why I was wheezy all day long even when watching tv

One day I went back because I was having issues with stomach acid and I was basically eating rennies every night to calm it down

I was put on omeprizole and within 2 days my acid was gone but so was the wheezing

For three months when on the course I went from taking my inhaler 8 times to day to genuinely not using it at all, I felt amazing! This is what normal feels like

The course ended and the acid and wheezing came back - the doctors are saying it’s unrelated but it can’t possibly be

Has anyone had anything similar

15 Replies

That's ridiculous that they're saying it's unrelated!

GERD is a known trigger for asthma but it is also often mistaken for asthma. So in some people they have GERD which then sets their asthma off. In others the GERD causes very similar symptoms to asthma but it isn't actually asthma, it's the GERD doing it. This sounds plausible in your case as your peak flow etc didn't seem to be affected. Essentially though, it doesn't matter whether it was "just" the GERD or GERD+asthma because clearly the omeprazole helped, treated the acid and so the breathing symptoms went which is what you needed - a classic case of treating the cause!

Are you on GERD treatment now? Sounds like you need to be on it long-term really. Maybe your GP would be more receptive if you used the angle that, after stopping the omeprazole, your GERD symptoms returned. But honestly I can't believe they've said it's unrelated! One only had to Google "GERD and wheezing" and it's all right there!

I have suffered Asthma and GERD for 40+ years, I am on many meds for asthma including Mepolizumab. I used to have boughts of losing my voice especially when being given new inhalers and was always told that's the reason. After having this problem for a while and seeing a new Dr at the asthma clinic, the Dr said to try double dosing on my inhalers for a couple of weeks, then double dosing on the Omeprazole, then double dosing on both, and I found doubling up on the Omeprazole gave me the best relief.

After having many investigations they found the acid was burning my vocal chords and I was given Esomeprazole, which I am still on now, but a lower dose.

In 2009 I was also put forward for surgery for a 'Nissan Laprascopic Fundoplication' and I have not looked back since

nbt.nhs.uk/our-services/a-z...

twinkly29 profile image
twinkly29 in reply to TuckBox2

Actually that's a good point that untreated acid reflux can do damage so Stephen's GP needs to be continuing to treat it, not dismissing it!

I had the same problem. I already had asthma which started when we got a cat in my forties. It was well controlled by Seretide. About 15 years later I developed a cough which, like yours, was so bad I was almost sick. It went on and on. I had several courses of antibiotics and chest X-ray, which did nothing and no-one seemed that bothered. Eventually after several years (!) I went to see a consultant and had a ct scan. He immediately diagnosed reflux as the cause of the cough. I was given Omeprazole and the cough literally disappeared immediately. I still take it every day. I tried reducing the dose and the cough came back.

This is not an unusual combination, in fact Asthma Uk say on their website that you are more likely to get reflux if you have asthma. I should go back and ask to go back on the Omeprazole.

Good luck. You are definitely not alone and your GP should know it is a common combination.

Melatonin can aid the healing of damage wrought by acid reflux and can, to some degree, reduce the reflux. We often think of melatonin as just a brain chemical that aids sleep but the stomach has more melatonin than the brain, its job being to aid the sphincter between the oesophagus and the stomach to work properly so that reflux doesn't occur. GERD isn't always about the over production of stomach acid but can be to do with a poorly functioning sphincter, low stomach acid (try apple cider vinegar to increase), diet (discuss with doctor) or hiatus hernia. Low stomach acid can result in a poorly functioning sphincter so this is an easy thing to discount by taking apple cider vinegar daily to see if there's an improvement in GERD symptoms. Personally, mine is a hiatus hernia and so what and when I eat is my personal solution.

Research has shown that patients can reduce their omeprizole use if melatonin is also taken and in some cases omeprizole only has to be taken occasionally. The side effects of long term use of omeprizole (it's only supposed to be used short term) is definitely a motive to find an alternative long term solution. It could be that your doctor is aware this PPI on a long term basis may be detrimental and that is why the prescription has stopped. But they should have a discussion with you about how you can address the ongoing problems suffered by GERD. Apart from asthma, ongoing GERD can damage to the oesophagus, voice, throat and mouth.

Per NHS website re omeprazole (link below):

ls it safe to take omeprazole for a long time?

If you take omeprazole for more than 3 months, the levels of magnesium in your blood may fall.

Low magnesium can make you feel tired, confused, dizzy and cause muscle twitches, shakiness and an irregular heartbeat. If you get any of these symptoms, tell your doctor.

Taking omeprazole for more than a year may increase your chances of certain side effects, including:

bone fracturesgut infectionsvitamin B12 deficiency – symptoms include feeling very tired, a sore and red tongue, mouth ulcers and pins and needles

If you take omeprazole for longer than 1 year, your doctor will regularly check your health to see if you should carry on taking it.

It's not known if omeprazole works less well the longer you take it.

If you feel like omeprazole is not working any more, talk to your doctor.

nhs.uk/medicines/omeprazole/

I forgot to mention mouth breathing. Some asthmatics tend to mouth breath rather than through the nose, this can, in some cases, affect the stomach as too much air is being digested and the result can exacerbate reflux.

MaggieHP profile image
MaggieHP in reply to Poobah

A very interesting add on to this is that having suffered from reflux (usually mild but with the occasional nasty flare) for ten years or more I recently ended up being referred on an urgent basis to an ENT specialist when I began to get a feeling of pressure on my larynx. It was not a pleasant sensation and it began not long after I began to reduce my medication for acid reflux after a 24 hour pH monitoring test revealed the amount of acid I was refluxing was on the low side of normal, despite the fact that the test required me to come off said medication seven days before the test to allow stomach acid levels to normalise. What was discovered when the ENT consultant checked things out was that I was producing abnormally high levels of nasal mucus despite being on Avamys nasal spray and having taken my daily dose of that a few hours earlier. In other words although I couldn’t feel it (I wasn’t snuffly and things didn’t feel irritated) I was still getting an allergic response in my nose. I’ve suffered from allergic rhinitis for as long as I can remember so I wasn’t overly surprised by this (though I was surprised that the Avamys didn’t appear to be knocking it as well as I felt it was). When I mentioned post nasal drip (also associated with reflux and asthma) the consultant replied that wasn’t a term he liked to use for what I had. Everyone can get post nasal drip, he said, what those who suffer from allergic rhinitis get is a little different, and it can cause irritation in the larynx. Given that my larynx looked absolutely fine, that was almost certainly at least partly responsible for what I was experiencing. I also got the impression that he felt it might be associated with some of the reflux symptoms I was having. What I haven’t been able to find out (and stupidly I didn’t pursue the matter further with the consultant) is whether allergic (and, apparently, non allergic) rhinitis can actually contribute to reflux or whether it only gives the feeling of reflux symptoms by causing irritation in the oesophagus etc. That is something to ask my gastro cons when I next speak to him. Searching online has revealed that there is recent research looking at a possible connection between rhinitis and silent reflux.

Going back to your point about breathing through the mouth, that is something that I sometimes do (I became aware that I was doing so whilst writing this), but given that I’ve suffered from allergic rhinitis pretty much all my life maybe that has become a habit from something that was originally a ‘must do’ because of a blocked nose when I was very small.

Poobah profile image
Poobah in reply to MaggieHP

I've had alot of nasal issues, including rhinitis and polyps (to me they felt like the size of grapes). It took me years to get things more or less under control. And anything I used in terms of nasal sprays always irritated my throat and oesophagus. However, post nasal drip is also irritating. It's either one thing or another. But I do find now that the more I focus on nasal breathing then the better my nose behaves. Chicken or the egg springs to mind. Anyone who has nasal polyps I would recommend looking at the possibility of an aspirin sensitivity which may mean that a low omega 6/high omega 3 diet will help.

As for stuffy and blocked nasal passages, I say stear clear of OTC decongestants as they will only work for a few days, after which they actually exacerbate the problems and can make things worse and they can be difficult to give up.

As well as prescribed nasal medicines it can be useful to practice nasal breathing (my asthma nurse encourages her patients to practice). More information about clearing nasal passages: youtu.be/tgmKIwUqhkg

MaggieHP profile image
MaggieHP in reply to Poobah

NSAIDS - and that includes aspirin - are something I’ve been told to steer clear of because of my stomach so I haven’t had them for years.

I was put on Avamys by my GP, but the consultant now has me on Dymista and a Neil Med sinus rinse (which I use in the evening). I have to admit they have really helped the situation and I’ve even been able to reduce the amount of Gaviscon Advance I’ve been requiring on top of the acid suppressants (I still don’t know why my consultant wants me to stay on the latter when the test results seem to indicate my stomach acid levels are fine - something else to ask him when we next speak).

Nasal polyps are something I don’t seem to get (looks around hastily for some wood to touch) and I have been checked for them more than once. Nasal sprays I’ve been on in the past have either resulted in sinus pain (not great) or nosebleeds (not pleasant either). Thus far the combination of Dymista during the day and the sinus rinse at night seems to be working well on both counts and I’ve had no issues. I’m keeping my fingers crossed it stays that way.

Poobah profile image
Poobah in reply to MaggieHP

I'll keep mine crossed too. 🤞 It can be a struggle to deal with every blooming thing that crops up. Sometimes I feel like I'm playing whackamole. I would definitely ask about the acid suppressant. Good luck!

MaggieHP profile image
MaggieHP in reply to Poobah

Thanks🙂.

Jinnty89 profile image
Jinnty89 in reply to MaggieHP

Hello MaggieHP, I am sorry to butt in here, but what you have written seems to sound like something I am experiencing. The feeling on your larynx, can you please tell me a little bit more what it felt like? Also, regarding omeprozole and nasal spray, I take both, the omeprazole because I was having severe burning in my throat, and on investigation, they found it was severely irritated, so I was placed on the opeprazole, but on a lower dose because I was told it can be a factor in memory loss. The nasal spray I have been on since I was a teenager, nearly 40 years ago, and no one has ever questioned it or asked why, but I’m now wondering if I should be asking some questions about it, what questions I don’t know, but surely it can’t be right being on it for over 40 years without being checked isn’t right? I was called by a physiotherapist to discuss my “mouth” breathing, and I was given exercises to try and minimise this, I will say it has helped me a lot, I’m no longer taking taking air sighs. But, I have been on inhalers since I was very young with asthma, but now lately I seem to be getting bouts of having a hoarse voice, which I’ve never had before, and this is worrying me a little. So, between that and the feelings I’m getting on my larynx I’m wondering if they are connected. Sorry for the long post, but I would really like your information about your symptom, if you don’t mind? Thank you and stay safe and well as you can be. X

MaggieHP profile image
MaggieHP in reply to Jinnty89

Hi Jinnty. The feeling with my larynx was just as if someone was pressing down on it and it was most uncomfortable. At first it was fairly sporadic; I’d get it for a few hours and then it would disappear. But in spring of this year it became persistent and I was having issues for most of the day and was even woken up by it at night. It was at that point I contacted my GP and she referred me immediately on an urgent basis to the Ear, Nose and Throat (ENT) unit. I was seen within a couple of weeks.

Like you I’ve been on inhalers for a long time (in my case over fifty years, though only thirty or so of them have been on steroid inhalers). For the past thirteen years I have had occasional bouts of oesophageal thrush (though never oral thrush) which have been put down to steroid inhalers by gastro consultants, although it is my personal feeling that other medication I was on at the time may have been a contributory factor. Nasal allergies, currently thought to be behind the problem with my larynx, though the reflux could be causing issues as well, is something I’ve suffered from for as long, if not longer than I’ve had asthma and I’ve had that for nearly fifty seven years.

Digestive issues, including reflux, have been recurring problem for thirteen years or so now, which is probably why my GP referred me on an urgent basis. Persistent reflux can cause long term damage to the oesophagus, and can also cause problems with the larynx as well as irritating the lungs (it’s not uncommon for asthmatics to develop problems with reflux though the mechanism involved is not yet understood; I understand that research in to this is ongoing).

If you are having problems with your larynx please get your GP to refer you to an ENT specialist. It really does need to be checked out.

Until you manage to see your doctor and discuss this issue further (and from what you’ve described it certainly sounds as though you have a reflux; if the GP concerned persists in saying no, then I suggest you seek a second opinion) there are other things you can do to help with reflux. My apologies if you are already doing some/all of these.

1) avoid certain foods. It’s known that various foods (spicy, fatty, citrus fruits, tomatoes, mint, onions, garlic, etc) can act as triggers for reflux

2) if you are overweight try to lose some of it. Being overweight will only make things worse

3) raise the head end of your bed by about six inches. Gravity is a wonderful thing and doing this will help to keep your stomach contents where they belong overnight. Don’t use pillows, you will slip off them during the night.

4) don’t wear clothes that could constrict or place pressure on your stomach

5) eat smaller portions of food and try to have your main meal of the day midday rather than in the evening

6) leave a minimum of three (ideally four) hours between your last meal of the day and going to bed. You need to go to bed with an empty stomach

7) don’t bend over, slouch etc for at least an hour after having eaten

Hope some of this helps.

I will just add that I went through something similar to what you are describing last year; I even had the feeling of iron bands around my chest. As with you, my peak flow was good. And to be fair to the doctors it can be very difficult to distinguish between asthma and reflux, particularly if the patient already has one or other of the conditions. The major difference is that I was already under consultant led care for digestive issues (and GI tract problems in general) and there was history of me having bouts of reflux affecting my breathing in the past, including one a few months earlier. So when ventolin did nothing for it but Gaviscon Advance helped to calm it down there was no doubt in my mind, nor in the mind of the doctors, as to what the problem was and I went straight back on the medication I had been put on a few months earlier.

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