Acid Reflux Disease
Acid reflux disease is caused by regurgitation of the stomach fluids into the esophagus. Normally, a ring-shaped muscle allows food to pass down the esophagus into the stomach, but it closes to keep acidic gastric fluids from backing up into the throat. Certain foods or medications may cause an excess of stomach acid, or the esophageal sphincter weakens and fails to keep the acids within the stomach. The lining of the esophagus is not designed to withstand the harsh acid and becomes irritated.
The symptoms of acid reflux disease are the result of the irritation caused by the acid rising up in the esophagus. The most common symptoms are heartburn, chest pain, sour taste and difficulty swallowing. Other less recognized symptoms are persistent cough and breathlessness, or dyspnea. Breathlessness associated with acid reflux is described as a suffocating feeling, tiredness or constriction in the chest, shortness of breath or labored or difficulty breathing. Symptoms of dyspnea are often worse at night or when lying down.
Shortness of Breath
Shortness of breath is a direct result of stomach acid in the esophagus. As the stomach acid is regurgitated into the espohagus, the acid stimulates the nerves in the lower end of the esophagus, causing muscles to contract. This contraction in turn causes small airways to constrict, which causes the feeling of breathlessness. The sensation worsens at night because when the body is in a prone position, it is easier for stomach acids to reflux into the esophagus. In some cases, an excess amount of acid in the esophagus may spill into the lungs, leading to a tightening of the airways and shortness of breath. The stress felt by people with acid reflux may also contribute to shortness of breath. However, this is less a function of the condition than the psychological outlook of the individual.
Breathlessness associated with acid reflux disease is treated by treating the underlying cause of reflux. Lifestyle changes such as reducing use of tobacco and alcohol, limiting fatty and spicy foods, and restricting caffeine, citrus fruits and tomatoes are recommended. Eat small meals and be sure to eat more than 3 hours before bedtime. If acid reflux continues, medications may be necessary. Antacids effectively neutralize excess stomach acid, but overuse may increase acid production. Other medications, such as proton pump inhibitors or beta-blockers, reduce the amount of acid produced by the stomach.