My doctor has told me that my asthma is being made worse by reflux disease. Is this a common problem for people with asthma? I am 50.

Donna

It is quite possible that GERD (gastroesophageal reflux disease) is associated with your asthma. Up to 75 percent of patients with asthma also have GERD.

Reflux may cause or aggravate asthma in either of two ways. First, stomach acids may reflux directly into the lung -- what we term aspiration. Or the acids may irritate the lower end of the esophagus, causing a reflex in the brain to stimulate the small airways (bronchial tubes) to become reactive.

It is not always clear whether reflux is causing asthma or if it is making existing asthma worse. Asthma occurring at night, after a meal, with an onset late in life, or without an allergic or seasonal component -- especially in a non-smoker -- should trigger a search for GERD. Also, if your asthma does not respond to conventional treatment, I would think of GERD.

Your doctor can determine if reflux is playing a role by doing a 24-hour monitoring study of your esophagus to see if too much reflux is occurring. Of your doctor might simply suggest trying a proton-pump inhibitor (a drug that inhibits acid production) for one to two months. If GERD is involved, the therapy should bring about improvement in your asthma.