Many conditions in pulmonary disease are connected.  Rheumatoid arthritis and pulmonary fibrosis, and lung cancer with asbestosis exposure, are just two of the examples of connections we can make between two seemingly unrelated conditions or events.  In the case of asthma, I have often mentioned that gastroesophageal reflux, which we call GERD, is often part of the reason it is difficult to control asthma symptoms.  I was recently reminded of the significance GERD has on asthma symptoms and how often it occurs. 59% of adults with asthma have GERD and about 29% of children are also affected.  Symptoms of GERD generally include a burning sensation in the chest and occasionally stomach contents coming up into the back of the throat.  However, a large number of patients with GERD have little or no symptoms. 

What is really important to know is that as the severity of asthma increases the reflux symptoms also increase.  There is one subgroup of patients with what is called “cough-variant asthma”.  The main symptom for this patient is cough which responds to asthma medications but GERD is frequently at the heart of the cough complaint. The treatment of GERD should be considered in asthma patients who have difficult-to-control symptoms.  A trial of medication, along with some dietary restrictions, can often improve asthma control.  There is a surgical option for some patients, which was shown to produce significant improvement in about 34% of patients.  The connection between GERD and asthma symptoms should be considered in all asthma patients.