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Acid Reducers May Not Help All With Asthma
Date:4/8/2009

Study finds benefit only for those with evident symptoms of heartburn

WEDNESDAY, April 8 (HealthDay News) -- Acid-suppressing medications won't ease asthma symptoms if you don't have heartburn symptoms, too, a new study has found.

Many people with asthma also have gastroesophageal reflux disease, or GERD. But some people have what's known as silent GERD, meaning they have no symptoms.

Doctors have suspected that if people with asthma breathe in during reflux, they might breathe irritating stomach fluids into the lungs. To reduce that possibility, doctors have been prescribing acid-suppressing medications known as proton pump inhibitors (PPI).

But a study in the April 9 issue of the New England Journal of Medicine repots that a PPI probably isn't going to help lessen wheezing in people with silent GERD.

"Patients with asthma that is not adequately controlled with the usual asthma medications, and who have no symptoms of heartburn, but who may or may not have silent GERD, don't seem to have any improvement of asthma when treated with esomeprazole (Nexium)," said one of the study's authors, Dr. Robert Wise, a professor of medicine in the division of pulmonary and critical care medicine at Johns Hopkins University School of Medicine in Baltimore.

Although the two conditions may seem quite different, doctors have long suspected that they're linked, with each disorder possibly triggering the other. Acid reflux might cause asthma symptoms through aspiration of fluid into the airways, or acid might irritate the esophagus and upper airway, according to the study. And asthma might trigger GERD when it causes difficulty breathing. The diaphragm may overinflate, and the extra pressure may cause the esophageal sphincter to herniate, allowing fluids to wash out of the stomach.

Proton pump inhibitors work by suppressing acid production.

The study, which was funded by the American
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