When a child has asthma, the possibility of the child also having
reflux should be investigated. It's been estimated that the
prevalence of reflux among asthma suffers range from 30 percent to 90
percent. Most kids will have typical symptoms of reflux (spitting up
or vomiting, excessive crying and irritability, etc) but some do not
express any outward symptoms. They are referred to as having silent
reflux. Their only symptom may then become asthma and many doctors may
not realize the link between reflux and asthma so the reflux never
gets diagnosed or treated. The child's asthma can then be difficult
to control with the normal medications.
How does reflux make asthma worse?
One possible reason is the acid that comes up the esophagus can
enter the airways, especially when lying down. This acidic refluxate
can cause the airways to narrow and create the wheezing and shortness
of breath associated with asthma. Over time, this refluxate can also
damage the airways worsening asthma symptoms. Another possibility is
acid reaching the lower part of the esophagus can stimulate nerve
endings causing the muscle in the airways to contract, narrowing
breathing tubes. This can be perceived as a shortness of breath.
How do i know if the asthma is reflux-induced?
Some indications that asthma could be caused by reflux are:
- The asthma symptoms get worse after eating, particularly high
fat foods
- Asthma like symptoms appearing with any other typical or
atypical symptoms of reflux
- Persistent cough, especially worse when lying down
It's important to remember that not all reflux will present typical
symptoms. In some cases the only symptom could be the presence of
asthma.
how is reflux induced asthma treated?
Treating reflux induced asthma may be as simple as treating the
reflux itself. All the usual
treatment methods apply to this type of reflux and as previously
stated, the asthma can usually be controlled by treating the reflux.
Of course, because everyone is different, it's not always that simple
for all kids and some could have stubborn cases that don't respond
well to treatment.
Reviewed By Dave Olson, MD
Fellow, American Academy of Pediatrics
Graduate University of Michigan School of Medicine
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