Asthma is common and the incidence is rising in all age groups. Gerd is likewise common and on the rise. Not all of the asthma patients have heartburn, but the MAJORITY will have GERD. This will likely shock you but up to 80% of asthma patients will manifest GERD by symptoms or by testing. Up to 80% of that group of asthma patients can obtain signifigant improvement and relief of their symptoms with appropriate therapy for atypical GERD. This means that of 100 asthma patients 64 could obtain substantial improvement IF treated aggressively for GERD. This may seem far fetched to the casual observer. This information is not speculation but fact. "Acid Related Diseases" by I. Modlin and G. Sachs, second edition,on page 400 starts the discussion of asthma and the relationship to GERD. The national asthma guidelines DO NOT reflect this information. At best they mention GERD, treating it as a curiousity. There are a whole series of unapparent reasons why a common therapy, generally considered very safe, with up to 80% improvement in over half of afflicted patients is given so little publicity. I won't go too far in speculating why this therapy is so slow to disseminate except to decry the compartmentalization of modern medicine. Why hasn't my doctor talked to me about this? Your doctor probably has not prioritized this topic for self study is the likely explanation. They are innundated with topics to stay current on. We as physicians often look to specialists to influence our knowledge and resultant treatment. The last seminar I attended barely touched on manifestations of GERD beyond the obvious digestive complaints. When the gastroenterologist spoke on GERD, heartburn was the topic emphasized and if quized about asthma the lecturer would respond,"I don't treat lungs". When the pulmonary specialist is approached about GERD/asthma the response I encounter is "I don't treat stomach diorders". Thus the patient lacks an advocate and often becomes "a man without a country". Since 2000 I have been increasingly conscious of the improvement in patient symptoms while treating atypical GERD. Decreased cough, less wheezing, improvement in sleeplessness, elimination of excessive mucus and reduction in congestion are common. The most profound improvement has been in eliminating infections and thus avoiding antibiotics. This lack of need for recurrent antibiotics is dramatic and quite remarkable. Antibiotics are not being rationed or withheld. They just are NOT needed.
The national asthma guidelines DO NOT reflect this information. At best they mention GERD, treating it as a curiousity. There are a whole series of unapparent reasons why a common therapy, generally considered very safe, with up to 80% improvement in over half of afflicted patients is given so little publicity. I won't go too far in speculating why this therapy is so slow to disseminate except to decry the compartmentalization of modern medicine. Why hasn't my doctor talked to me about this? Your doctor probably has not prioritized this topic for self study is the likely explanation. They are innundated with topics to stay current on. We as physicians often look to specialists to influence our knowledge and resultant treatment. The last seminar I attended barely touched on manifestations of GERD beyond the obvious digestive complaints. When the gastroenterologist spoke on GERD, heartburn was the topic emphasized and if quized about asthma the lecturer would respond,"I don't treat lungs". When the pulmonary specialist is approached about GERD/asthma the response I encounter is "I don't treat stomach diorders". Thus the patient lacks an advocate and often becomes "a man without a country".
Since 2000 I have been increasingly conscious of the improvement in patient symptoms while treating atypical GERD. Decreased cough, less wheezing, improvement in sleeplessness, elimination of excessive mucus and reduction in congestion are common. The most profound improvement has been in eliminating infections and thus avoiding antibiotics. This lack of need for recurrent antibiotics is dramatic and quite remarkable. Antibiotics are not being rationed or withheld. They just are NOT needed.