Are Asthma and Acid Reflux in Children Related?

Any breathing difficulties can send us into a parenting panic- be it asthma or reflux related.

Are you currently navigating life with new symptoms of acid reflux in your child and need more information on acid reflux in children and adolescents? Well, you are in luck because we have just the article for you!

Whether you know that your child has acid reflux or not, does your child also struggle with asthma? Or maybe, your child only struggles with asthma, but no acid reflux. Have you ever wondered if the two could be related?

Well, the relationship between GERD and respiratory diseases, specifically asthma, in children remains unanswered. However, it is thought that reflux occurs in 25-75% of children with persistent asthma. Many studies have shown improvement in asthma when patients are treated for GER (also referred to as acid reflux or heartburn), however, pinpointing patients who are likely to respond to treatment remains hard.

For those children and adolescents who have asthma with symptoms that heavily suggest GERD (a more serious form of GER), a three-month trial of acid suppression medication is recommended to see if symptoms improve.

For some, there may be an absence of GERD symptoms in children with asthma. If a child lacks seasonal or allergic symptoms and has the following symptoms, a three-month trial of acid suppression medications or esophageal pH testing may be appropriate:

• Nocturnal asthma more than once a week
• Continuous need for oral corticosteroids
• High-dose inhaled corticosteroids
• More than two courses of oral steroids per year
• Persistent asthma that does not allow the person to be weaned from medical management

A study done by Khoshoo et al. supports the theory that treating a child with asthma with acid-reducing medications may be helpful. Their inclusion criteria are as follows. The patient must have:

• Had no family history of asthma
• Had no personal/history of atopic disease
• Had been receiving treatment for asthma for at least 2 years
• Had parents who did not smoke
• Had at least three emergency visits or hospital admission per year
• Required a combination of short- and long-acting bronchodilators, leukotriene antagonists, and inhaled corticosteroids for the management of asthma

All of the patients were using the long-acting bronchodilator daily before medications were used to treat GER. They found that >50% of their participants had a reduction in bronchodilator use over the 6-month posttreatment period using acid-suppressing medications as compared to the pretreatment period. There was also a significant reduction in inhaled corticosteroid use with GER treatment.

If your child has asthma, it does not necessarily mean they automatically have acid reflux. However, if your child does struggle with asthma, hopefully, this article will help look at uncommon reasons for their asthma and can provide help with their symptoms! If you suspect your child may be struggling with any of these symptoms, please consult your medical provider for further evaluation.

1. _{Winter, H. S. (n.d.). Clinical manifestations and diagnosis of gastroesophageal reflux disease in children and adolescents. UpToDate. Retrieved February 27, 2023.}
2. _{Khoshoo, V., Le, T., Haydel Jr, R. M., Landry, L., & Nelson, C. (2003, April). Role of gastroesophageal reflux in older children with persistent asthma. Retrieved February 27, 2023.}