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Medical Author:

Dennis Lee, MD

Dennis Lee, MD

Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.

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Medical Author:

George Schiffman, MD, FCCP

George Schiffman, MD, FCCP

Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.

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Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Unusual symptoms of asthma
• Can a cough without wheezing be due to asthma?
• Nocturnal asthma
• Masqueraders of asthma
• Cardiac asthma
• Other bronchial conditions
• Vocal cord dysfunction (VCD)
• Other hypersensitivity reactions
• Exercise and sports
• Exercise induced asthma (EIA)
• What causes exercise induced asthma?
• What sports are best suited for exercise induced asthma? What sports are not?
• Ways to prevent and treat exercise induced asthma
• Conditions that may worsen asthma
• Gastroesophageal reflex disease
• The allergic rhinitis-asthma connection
• Sinusitis and asthma
• Air pollution
• Food allergy
• Asthma Complexities At A Glance
• Find a local Asthma & Allergy Specialist in your town
• Asthma Complexities Index

GERD is a common condition caused by the regurgitation (reflux) or backwash of stomach acid into the esophagus from the stomach. At times, the acid even may regurgitate into the back of the throat and reach the lungs. GERD usually -- but not always -- is associated with a burning discomfort under the breastbone, called heartburn, which occurs mostly after meals or when lying down. In some patients, the symptom of acid reflux is not heartburn. Instead, they experience coughing, wheezing, hoarseness, or sore throat.

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 asthma patients more susceptible to acid reflux. For example, theophylline, an oral medication 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 patients with nocturnal 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 omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex), lansoprazole (Prevacid), and esomeprazole (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 severe cases of GERD that do not respond to medications.