Unusual Asthma Symptoms
Health Conditions That May Worsen Asthma continued...
The presence of acid in the esophagus or the passage of acid into the lungs (aspiration) may cause the bronchial tubes to constrict (bronchospasm), causing wheezing and coughing that may not respond to medications for asthma. Bronchospasm related to acid reflux tends to occur more frequently at night as a result of lying down. Interestingly, GERD is common among patients with asthma. Some doctors believe that asthma itself or asthma treatments in some way make people with asthma more susceptible to acid reflux. For example, theophylline, an oral asthma medication (bronchodilator) that's occasionally used to treat asthma, may promote acid reflux by relaxing the specialized muscles in the esophagus that normally tighten to prevent regurgitation of acid.
In people with nighttime asthma or difficult to control asthma, treating acid reflux may help relieve coughing and wheezing. Treatment of GERD involves elevating the head of the bed, losing weight, avoiding spicy food, caffeine, alcohol, and cigarettes. Proton pump inhibitors such as Prilosec, Protonix, Aciphex, Prevacid, and Nexium are potent inhibitors of production of acid in the stomach and are effective treatments for asthma aggravated or caused by acid reflux. Rarely, surgery is performed to prevent acid reflux for people with severe GERD that does not respond to medications.
For more information, see WebMD's article on Heartburn and Asthma.
Allergic Rhinitis and Asthma
There is a clear association between allergic rhinitis (hay fever) and asthma. The question of which comes first -- the allergic rhinitis or the asthma -- is not easily answered. Allergic rhinitis is considered a risk factor in developing asthma -- up to 78% of those with asthma also have allergic rhinitis.
Many people with asthma recall developing their asthma and nasal symptoms (sneezing, congestion, a runny nose, and itchiness in the nose) at or about the same time. Others developed their asthma either before or after the onset of their allergic rhinitis. We now know that almost all people with allergic asthma also have allergic rhinitis. Allergic asthma is the most common type of asthma. Additionally, roughly one third of persons with allergic rhinitis will develop asthma. People with both conditions can expect to suffer more severe asthma attacks and require stronger medications to prevent their asthma symptoms. People with allergic rhinitis should be vigilant about reporting any persistent coughing or wheezing to their doctors. Sometimes allergy tests are done to isolate allergy and asthma triggers and allergy shots (immunotherapy) are given to reduce asthma symptoms. In addition, the presence of asthma can easily be determined with lung function tests.