If your doctor suspects asthma and acid reflux, he or she may try a therapeutic trial rather than performing a lot of tests. The following asthma conditions are more likely to benefit from acid reflux treatment:
Possible Treatments for Asthma and Acid Reflux
Your doctor may suggest a proton pump inhibitor (PPI) in addition to lifestyle modifications in hopes of improving your asthma and acid reflux. Generally, PPIs are taken twice daily before breakfast and dinner. Treatment with a PPI may:
- Decrease nighttime asthma symptoms
- Decrease frequency and severity of asthma exacerbations
- Improve quality of life
A Successful Therapeutic Trial
A therapeutic trial is thought to successfully diagnose acid reflux as the cause of asthma if:
- Peak flows improves by 20%
- Inhaled steroid dose can be decreased by 20%
- Symptoms improve
If your asthma symptoms improve or you have improvement in your lung function, your doctor will likely continue the medication started in your therapeutic trial, but may try to prescribe lowest dose needed to prevent your asthma and acid reflux symptoms. If your GERD improves but your asthma does not, your doctor will manage your GERD according to standard GERD treatment.
Can Surgery Improve My Asthma and Acid Reflux?
Surgical treatment may reduce the symptoms of asthma and also decrease the requirement for medication. Surgical treatment for GERD, however, remains controversial. In early studies comparing medical treatment to surgery, surgery appeared to be more effective. However, long-term studies where patients received either surgery or medical therapy have demonstrated that nearly 2/3 of patients receiving surgery are back on medical therapy 10 years later.
In asthma, the following indicators appear to be predictive of good surgical outcomes:
- Typical reflux symptoms that result completely with medical therapy
- Surgery at age 50 years or younger
Sources:
Littner MR, Leung FW, Ballard ED, Huang B, Samra NK. Effects of 24 weeks of lansoprazole therapy on asthma symptoms, exacerbations, quality of life, and pulmonary function in adult asthmatic patients with acid reflux symptoms. Chest 2005;128(3):1128–35.
Sontag SJ, O'Connell S, Khandelwal S, Greenlee H, Schnell T, Nemchausky B, Chejfec G, Miller T, Seidel J, Sonnenberg A. Asthmatics with gastroesophageal reflux: long term results of a randomized trial of medical and surgical antireflux therapies. Am J Gastroenterol 2003;98(5):987–99.
