Acid Reflux Bad Breath
GERD bad breath is an unpleasant manifestation of chronic heartburn. When stomach acid ends up in the mouth cavity, it can erode hard tissues and tooth enamel. This creates cavities that trap food where bacteria can feed and multiply.
Often, your dentist can tell whether bad breath is caused by acid reflux or because of poor dental hygiene and smoking that also cause dysbiosis of the oral microbiome. GERD patients tend to have teeth erosion, redness around the tonsils, tongue and gum irritation, and sour breath.
TIPProper dental hygiene and over-the-counter medications can usually alleviate bad breath in a week or so.
Lifestyle And Dietary Changes
Lifestyle and dietary changes make a significant impact on people with GERD. If you have GERD or acid reflux, try these steps:
- Avoid foods and drinks that trigger GERD .
- Eat smaller meals, especially in the evenings.
- Dont eat within three hours of bedtime.
- Elevate your head for six to eight hours while sleeping, and sleep on your left side.
- Lose weight if advised.
Over-the-counter and prescription medications can help treat GERD and acid reflux. These include:
- Antacids, like Tums, which neutralize stomach acid
- H2-receptor blockers, like Pepcid Complete or Pepcid AC , block the production of stomach acid
- Proton pump inhibitors, like Prilosec , Nexium , and Protonix , also block stomach acid production
If youre taking Tums frequently or for more than two weeks, you should see your healthcare provider about acid reflux.
Treatment For Asthma Emergencies In Children
An asthma attack can quickly become an asthma emergency, but if you take quick action, you can reduce the risk of this happening. So, if the symptoms of an asthma attack appear, follow your childs asthma action plan.
If your child is experiencing a severe or life-threatening asthma attack, call triple zero for an ambulance and then start asthma first aid.:
- Sit the child upright.
- Give 4 puffs of reliever medication , taking 4 breaths for each puff. Use a spacer and mask if one is available.
- Wait 4 minutes if the child still cannot breathe normally, give 4 more puffs.
- Continue to give 4 separate puffs of reliever medication, taking 4 breaths for each puff, every 4 minutes until the ambulance arrives.
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Medications That Can Cause Acid Reflux Rebound
Even some anti-heartburn medications can lead to an increase in stomach acid. This phenomenon, which is called acid rebound, is the bodys attempt to override an acid suppressing medication. In other words, your stomach may react to an acid suppressant by producing even more acid. This can cause very painful heartburn symptoms.
Acid rebound most often occurs when you take a medication called a proton pump inhibitor for a few weeks or longer and then stop. According to , the New Zealand Medicines and Medical Devices Safety Authority, the withdrawal from PPIs can cause severe heartburn symptoms. Medications that may cause acid rebound include:
Some studies have suggested that OTC antacids, such as Tums , can also increase the stomachs secretion of acid. In this case, acid rebound may occur because the stomach works to replace the acid that was just neutralized.
If you want to stop taking PPIs or OTC antacids, talk to your doctor about alternatives. You may first need to wean yourself off the medication instead of going cold turkey. From there, your doctor might suggest lifestyle changes and alternative medicines, such as an H2 blocker like famotidine or a prokinetic agent.
Gerd May Be Causing Your Uncontrolled Asthma Symptoms
If your asthma is uncontrolled, especially if you are having nighttime symptoms, gastroesophageal reflux disease may be to blame. As many as 75% of patients with difficult to treat asthma also experience frequent heartburn. GERD is one of the most common conditions that contribute to uncontrolled asthma, and you may need to get evaluated. Symptoms of GERD include:
- Regurgitation or the sensation of the acid and your food backing up the wet burp is another way patients sometimes describe this
- Frequent heartburn or pyrosis, the painful burning in your stomach and mid-chest caused by acid from your stomach going up into and irritating your esophagus
- Sour or bitter taste in your mouth. Depending on the severity, the reflux may cause a sour or bitter taste, or you may get a sudden sensation of a salty fluid in your mouth called water brash. Water brash results from the stomach acid stimulating salivary glands to produce saliva
Roy Morsch / Corbis / Getty
Acid is normally prevented from going up into the esophagus from the stomach by a muscular ring that is present at the junction of the stomach and esophagus. When this ring relaxes acid can move from the stomach upward. Once acid is in the esophagus, it is possible for you to aspirate it into the lungs. Another hypothesis is that acid entering the esophagus stimulates nerves there and triggers airways to narrow.
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Why Asthma May Trigger Gerd
Just as GERD can make asthma symptoms worse, asthma can exacerbate and trigger symptoms of acid reflux. Pressure changes that occur inside the chest and abdomen during an asthma attack, for example, are believed to aggravate GERD.
As the lungs swell, the increased pressure on the stomach may cause the muscles that usually prevent acid reflux to become lax. This allows stomach acid to flow back up into the esophagus.
Heartburn is the main GERD symptom that adults face. In some people, GERD can occur without causing heartburn. Instead, symptoms may be more asthmatic in nature, such as a chronic dry cough or difficulty swallowing.
Your asthma may be connected to GERD if:
- it began in adulthood
- symptoms get worse following a large meal or exercise
- symptoms occur while drinking alcoholic beverages
- symptoms happen at night or while lying down
- asthma medications are less effective than usual
It can be difficult to identify symptoms of GERD in children, especially if theyre very young. Infants under age 1 will often experience symptoms of acid reflux, such as frequent spitting up or vomiting, with no harmful effects.
In general, infants and young children with GERD will:
- become irritable
- arch their backs often
Other Tests For Conditions That May Mimic Asthma
There are some medical conditions that often make asthma harder to treat and control, in addition to being asthma mimics. These include allergies and GERD. If you are diagnosed with asthma, your doctor might also test you for these conditions, or treat them for several weeks to see if your asthma symptoms also improve.
For more information on allergies, GERD, and other triggers, see Causes of Asthma.
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The Relationship Between Asthma And Gerd
A relationship between asthma and GERD was first found in the 1960s when patients reported their asthma symptoms were eliminated after surgery for acid reflux.
Researchers and clinicians believe there are two mechanisms at play:
In the leading theory, the acid reflux erodes the epithelial layer of the mucosa, exposing vagal nerve endings. The esophageal receptors become more sensitive to refluxed acid. The receptors then trigger bronchospasms.
“Acid reflux is an important trigger for asthma,” says Benjamin Interiano, MD, associate professor of medicine in the pulmonary section at Baylor College of Medicine in Houston. In fact, reflux may be the sole cause of symptoms in some asthmatics.
In a less-common theory, patients aspirate gastric acid into the lungs. Recent research shows this is not likely to be a primary cause of reflux-triggered asthma.
Coughing also may promote reflux. It weakens the sphincter, allowing for reflux, says Frederick Leickly, MD, associate professor of medicine at the Indiana University School of Medicine and a pediatric pulmonologist at Riley Hospital for Children, which is affiliated with the School of Medicine in Indianapolis.
Just how many asthmatics also suffer from GERD remains unclear. Identifying acid reflux has become much more effective, so clinicians diagnose more people with it.
Experts point to these clues that GERD may be aggravating asthma:
Effects Of Asthma On Gastroesophageal Reflux Disease
Pathophysiologically, asthma may predispose an individual to the reflux of gastroduodenal contents into the esophagus by a variety of mechanisms, including the following: increased intrathoracic pressure, vagus nerve dysfunction, altered diaphragmatic crural function, and decreased lower esophageal sphincter pressure due to medical therapies for asthma .,
Patients with asthma often have lung hyperinflation. Changes in the pressure gradient between the stomach and the esophagus may develop from the increased work of breathing and lung hyperinflation, which can then result in a herniation of the LES into the chest, impairing the barrier to reflux and potentially causing continued reflux due to decreased LES pressure. The complex problem of identifying the relationship between asthma and GERD is that, in a given patient with asthma, it is difficult to discern the inciting factor. Thus, in a given patient with difficult-to-control asthma, the response of the pulmonary symptoms to empiric GERD therapy is often used clinically to determine whether the 2 problems are causally linked.
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Causes Of Acid Reflux
When food enters the stomach, there is a valve at the end of the esophagus that should close upon its arrival. If that valve malfunctions, it allows acid to flow back up into your mouth and throat. Thats what causes the sour taste in your mouth when you experience acid reflux.
Some factors that could lead to the problems with the valve closing properly include:
- Having too much pressure placed on the abdomen
- Eating specific types of food
- Your general eating habits
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Is There Surgery To Treat Gerd
GERD is usually controlled with medications and lifestyle changes . If these dont work, or if you cant take medications for an extended period, surgery may be a solution.
- Laparoscopic antireflux surgery is the standard surgical treatment. Its a minimally invasive procedure that fixes your acid reflux by creating a new valve mechanism at the bottom of your esophagus. The surgeon wraps the upper part of the stomach around the lower portion of the esophagus. This reinforces the lower esophageal sphincter so food wont reflux back into the esophagus.
- LINX deviceimplantation is another minimally invasive surgery. A LINX device is a ring of tiny magnets that are strong enough to keep the junction between the stomach and esophagus closed to refluxing acid but weak enough to allow food to pass through.
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Chronic Pain And Blood Vessels
Smoking can generate general body painblood vessels
blood flow and circulationmuscles, tendons, and the other spinal structures, like the discs
- Smoking contributes to continued inflammation, which can increase pain
- It can interfere with prescribed medications for pain management/other conditions
- Proper absorption of minerals, nutrients, chemicals, medications, is disrupted
- Damage to the spinal discs and facet joints
neuron stimulation from the nicotine
Acid reflux, which is usually heralded by heartburn, is unpleasant enough when it occurs only occasionally. For up to 20 percent of American adults, acid reflux is a frequent occurrence that significantly diminishes their quality of life. Obesity, diet, smoking and a variety of other factors have been linked to acid reflux, and your physician may have urged you to address some of these issues. However, if you have not reviewed your medication list, you may be missing a key element in your treatment plan.
What Do I Do If I Think I Have Gerd
With GERD when reflux and heartburn happen more than once in a while the tissue lining your esophagus is getting battered regularly with stomach acid. Eventually the tissue becomes damaged. If you have this chronic acid reflux and heartburn you can see its affecting your daily eating and sleeping habits.
When GERD makes your daily life uncomfortable in this way, call your healthcare provider. Although GERD isnt life-threatening in itself, its chronic inflammation of the esophagus can lead to something more serious. You may need stronger prescription medications or even surgery to ease your symptoms.
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What Can I Do If Im Not Sure
You should first ask yourself how typical the symptoms seem: Are they different from those you usually have during the pollen season? Symptoms like sneezing and itchy eyes are very likely to be caused by an . But hay fever can also cause allergic symptoms such as a cough or shortness of breath, which are associated with COVID-19 too.
Its also possible to have both hay fever and a coronavirus infection at the same time. If you have an unusual cough and fever as well as symptoms, its likely that you have a respiratory infection .
If youre still not sure, its a good idea to find out whether it would make sense to be tested for COVID-19.
Note: Rapid tests for coronavirus antibodies that you can buy at a pharmacy cant tell for sure whether or not you have an acute coronavirus infection.
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Diagnosis Of Gastroesophageal Reflux Diseaserelated Asthma
The diagnosis of GERD-related asthma based on the presence of symptoms of heartburn or regurgitation is difficult because patients with asthma do not always have these classic symptoms of GERD. It is important to recognize that there are no diagnostic gold standards in this area. The roles of esophagogastroduodenoscopy , barium esophagography, and esophageal pH and impedance monitoring are still controversial. EGD and barium esophagography are limited by their inability to detect a temporal relationship between episodes of reflux and asthma or cough. The presence of esophagitis, which is not common at endoscopy in this group,25 suggests GERD but does not implicate reflux in primary symptoms of asthma. Leggett and colleagues9 used 24-hour ambulatory pH monitoring with dual probes to assess GERD in patients with difficult-to-control asthma. The prevalence rates of reflux at the distal and proximal probes were 55% and 35%, respectively. However, the presence of reflux on pH monitoring does not necessarily suggest a causal link to asthma exacerbation.
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How Do They Affect Each Other
Its not yet clear why reflux and asthma occur together or if one causes the other. However, it is known that they can affect each other, making each condition worse in something of a vicious circle.
In some cases, acid may be stimulating the nerves in your esophagus. This may trigger the nerves to tell your esophagus and larynx to protect itself from the acid. Mucous production may increase and a cough reflex may also be triggered. In other cases, acid directly injures the lining of your throat, airway, and lungs, which makes breathing difficult and causes a cough, or causes an inflammatory reaction in the lower airway, creating an asthma attack, Dr. Kessler said.
On the other hand, it is possible for asthma medicines to make your symptoms worse. This is most likely to occur with the asthma drug theophylline. Inhaled steroids used for asthma may increase symptoms that are similar to LPR.
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How And When You Eat Can Affect Acid Indigestion
The common phenomenon of acid reflux, or heartburn, is a symptom of a very uncomfortable issue. Many people have experienced the troublesome feeling of acid coming up from their stomach and burning in their throat after a meal. This burning sensation can be very painful and leads to a loss of appetite. Acid reflux occurs when food inflames your lower esophageal sphincter, which is the valve that keeps the contents of your stomach from spilling into your esophagus.
Acid indigestion can be caused by eating too quickly, eating fatty foods, consuming acidic foods, not chewing food well enough, and smoking. Some practical ways to alleviate acid indigestion are to chew food more thoroughly before swallowing, avoid foods that cause the problem in the first place , stop smoking, drink fluids between meals and snacks, and reduce stress.
When you are done eating a meal, prevent acid reflux by chewing on some gum. More saliva is produced when you chew some gum. The more saliva that is produced during digestion, the less acid is produced, in turn, preventing acid reflux from occurring. Ideally, you should chew on sugar-free gum.
Many people like to lie down and relax after eating a big meal. This is bad for the digestive system and can lead to acid reflux. Instead, try walking around or standing to give the food a chance to digest. Wait at least two hours after eating to lie down. Also, elevate your body while sleeping.
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Hay Fever And Other Allergies
If youve got asthma you can often have other allergic conditions too. Sometimes you can have one or more of these allergies at the same time.
- Allergic rhinitis is the most common of all the related health conditions. Hay fever is allergic rhinitis triggered by pollen, usually during the summer months. But you can also have allergic rhinitis all year round, triggered by dust mites, pets or mould. If you have a blocked, runny, itchy nose, or sneeze a lot, it could be rhinitis.
- Eczema is an allergic condition that causes dry, cracked and itchy skin. Eczema often runs in families, alongside asthma and allergic rhinitis.
- Food allergies can also be seen alongside other allergies like asthma, allergic rhinitis or eczema.
How allergies affect your asthma
Allergies can make your asthma symptoms worse – like coughing, wheezing, tight chest and feeling breathless. This can increase your risk of an asthma attack.
If you have a food allergy and asthma, youre more at risk of a life-threatening asthma attack.
How to lower your risk of symptoms
- Ask for allergy tests to confirm or rule out allergies to pets, pollen or dust mites
Find out more about allergic triggers like pollen, food and dust mites.