The Digestive Health Institute, Watertown MA, recently completed a clinical study on a diet with low “fermentation potential” in people with chronic reflux symptoms at least three times per week. We are excited about the results which are summarized in the new book, Fast Tract Digestion Heartburn, available as an ebook on Amazon.
After reading a recent CNN article called “Burgers Hinder Breathing” Linking fast food to asthma, I commented that I believe the link between fast food and asthma is no different than the link between acid reflux and asthma. I went on to explain my research findings on the cause of GERD and how GERD, carbohydrates and asthma may be linked. After several requests, I agreed to publish an excerpt from my upcoming book Fast Tract Digestion to provide more details on the connection between GERD, carbohydrate malabsorption and asthma.
On the surface, GERD and asthma appear to be quite separate conditions with little in common. Asthma is a chronic inflammatory lung disease that causes narrowing of the airways, affecting over 20 million people in the US including up to 6 million children. Symptoms include: wheezing, coughing, difficulty breathing, tightness in the chest and flare-ups associated with allergic reactions or following exercise. The exact cause of asthma is unknown, but both genetic and environmental factors are involved. Flare-ups of asthma appear to be allergic in nature as most people with asthma have specific allergies. Allergens that can trigger attacks include cat or dog dander, dust mites, cockroaches, mold and other irritants like cigarette smoke. Asthma diagnosis is made based on a physical exam, breathing tests and a review of one’s medical history.
GERD, which stands for gastroesophageal reflux disease, is a chronic condition caused by the repeated refluxing of stomach contents into the esophagus. Approximately sixty million people in the US suffer with GERD symptoms. The most common symptom is heartburn, described as a burning sensation behind the breastbone. Other GERD symptoms include abdominal pain, cough, sour taste, sore throat, hoarseness, laryngitis, asthma like symptoms (one sign of a possible link) and sinus irritation. Smoking, pregnancy, obesity, hiatal hernia and tight fitting clothes can make symptoms worse.
During acid reflux, the group of muscles at the top of the stomach, called the lower esophageal sphincter or LES, are unable to keep the stomach’s contents from entering the esophagus. The esophagus is not protected by the same mucous layer that coats the inside of the stomach. The result is painful damage to the esophagus. Diagnosis of GERD is generally accomplished by a doctor reviewing a patient’s symptom history in detail including frequency of heartburn, and related symptoms. If diagnostic tests are required, they may include upper gastrointestinal endoscopy that allows your doctor to look at the lining of your esophagus, stomach and first part of your small intestine using a miniature camera. Damage or irritation to the lining of the esophagus is a common hallmark of GERD. If symptoms persist, additional tests may include manometry to measure how tightly your LES closes as well as 24 hour pH monitoring to measure how much acid is leaking into your esophagus and how long it remains there.
For some time a connection between asthma and GERD has been recognized but the reason for the connection has remained a mystery. As many as 80 percent of asthmatics suffer from abnormal gastroesophageal reflux compared to about 20 – 30 percent of non asthmatics (1). Some asthmatics have GERD with classic symptoms while others shown to have GERD by pH monitoring don’t have classic symptoms and are considered to have “silent GERD”(3). A better understanding of the underlying cause of GERD may shed more light on the connection between GERD and asthma.
