Joann Reed, NP-C

Nurse Practitioner (NP)
Allergy
Provide Feedback
Allergy & Asthma Center of Southern Oregon
3860 Crater Lake Avenue
Suite A
Medford, Oregon 97504 [MAP]
For an appointment , call (541) 858-1003
Learn More

Gastric Reflux (GERD) & Asthma

  1. Asthma (especially nighttime and early morning asthma) can be significantly worsened by gastroesophageal reflux disease (also called GERD or heartburn). This occurs mainly because nerves provoked by esophageal irritation or burning are also the same nerves that can squeeze the airways in the lung. Therefore, pain in the esophagus triggers a reflex constriction in the airways and asthma symptoms.  Acid spilling up the esophagus can also directly inflame the upper throat or vocal cords and may be aspirated into the upper airways at time.
  2. To avoid heartburn (G.E.R.D.) we recommend that patients should avoid certain factors that trigger acid secretion or reflux. These include caffeine, tea, Theophylline, alcohol, aspirin, or nonsteroidal pain medications (Motrin, Advil, Indocin, etc.), and spicy foods. The patient should also try to avoid chocolate and acidic juices such as orange juice or grapefruit juice, which can also cause increased gastroesophageal reflux.
  3. One very helpful strategy is to raise the head of the bed 2-4 inches off the ground. This is done by placing the headboard of the bed on 3 inch thick wood blocks or possibly bricks or old books or some other objects to help raise the entire head of the bed. Tilting the bed allows gravity to help keep acid in the stomach and prevent acid from trickling up the throat into the mouth. Using multiple pillow actually can worsen reflux as it causes bending at the waist, which increases the pressure on the stomach.  This can actually squeeze acid up into the throat.  Therefore, rather than using extra pillows it is better to tilt the entire bed or possibly obtain a wedge for the upper part of the bed.
  4. Medications:
    • First we recommend patients avoid meals or foods prior to sleep, particularly in the 2-3 hours before sleeping.
    • Antacids (Maalox, Mylanta, Tums etc.) may be used every four hours as needed basis.  These often are helpful in preventing heartburn.
    • H2 blockers (Pepcid, Zantac, Cimetidine, Axid) are often used for chronic reflux.
    • The most effective pills for marked GERD are hydrogen ion pump blockers such as Prilosec, Nexium, Prevacid, Aciphex, Protonix etc. which can be used. 
    • Other medications such as Carafate, are also occasionally used daily as needed.