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Adult Onset Asthma

The esophagus and trachea (windpipe) are in close relationship. GERD is common in patients with asthma and has been identified as a potential trigger for asthma, and patients with GERD may have asthma-like symptoms.

Asthma and Heartburn Relationship

There is a mutual cause-and-effect relationship between asthma and GERD. In some situations, reflux disease can actually cause the asthma, particularly adult-onset asthma. In other cases the GERD can potentiate existing asthma, making it difficult to control. In addition, asthma symptoms such as cough and wheezing magnify the difference in pressure between chest (negative pressure) and abdomen (positive pressure), encouraging GERD.

Causes of Asthma-Like Symptoms

GERD can cause asthma-like symptoms via two mechanisms:

  • Aspiration of acid particles in the trachea can cause coughing, wheezing and pneumonia
  • Acid in the esophagus causes a reflex phenomenon in the trachea, triggering asthma-like symptoms.

Thus, it is important for physicians to consider the possibility of GERD when treating patients with lung problems.


Patient may have the common symptoms of reflux, including heartburn, difficulty swallowing and regurgitation.

However, as a result of the close relationship between the esophagus and windpipe, many patients may present with uncommon breathing symptoms including:

  • Chronic cough
  • Hoarseness (voice change)
  • Wheezing
  • Pneumonia
  • Aspiration

Chronic aspiration of gastric acid and bile (non-acidic fluid), which typically occurs at night when patients are lying down, can severely damage the lungs and vocal cords. Long-standing aspiration can even cause severe pulmonary disease such as pulmonary fibrosis.