Kirsty Brydges used to take deep breaths through her inhaler in the hope that it would relieve her shortness of breath.
“I was wheezing and coughing all the time,” says Kirsty. “I had to sleep on pillows and felt terrible.
“I also have a hoarse voice. I was afraid there was something seriously wrong with me, not just asthma.”
Kirsty was diagnosed with the disease at the age of 38 and was put on an inhaler containing the drug salbutamol, which improves breathing by relaxing the muscles in the airways.
But no matter how many blows Kirsty got, nothing helped. Because six years after her asthma diagnosis, the true cause was determined.
She even had acid reflux — or gastroesophageal reflux disease (GERD), in which stomach acid repeatedly backs up into the esophagus, the tube that connects the mouth and stomach — usually because of pressure or problems with the valve that connects it.
Exactly how much is misdiagnosed is unclear, but a 2017 study in the Journal of the American Medical Association suggests it’s relatively common
But for some, the symptoms can be confused with asthma because stomach acid rises too much, can enter the airways, irritate the lungs and cause breathing problems.
For some with GERD, this shortness of breath may be their only symptom—hence the room for confusion.
Exactly how many are misdiagnosed is unclear, but a 2017 study in the Journal of the American Medical Association suggests it’s relatively common.
When 613 people diagnosed with asthma were subjected to formal tests (eg peak flow, which measures the ability to exhale air in one breath), it was found that a third did not have the condition, but others, including BUOO.
“GERD is incredibly common,” says Jonathan Hoare, a gastroenterologist at Imperial College Healthcare NHS Trust in London, who adds, “No one has the perfect valve at the bottom of the esophagus.
“Ten per cent of the population will report reflux within a month – asthma affects 5.4 million people in the UK – and GERD usually occurs at the same time. If someone has asthma, reflux can trigger and worsen the asthma.”
When it comes to why reflux makes asthma worse, one theory is that acid rising into the esophagus stimulates the vagus nerve, which can constrict and narrow the airways.
The vagus nerve, which connects the brain and gut, oversees many important bodily functions, including digestion and breathing.
“The other theory is that potentially small amounts of acid can travel all the way up and into the lungs, causing irritation and narrowing of the airways, the same symptoms as asthma,” says Dr. Whore. But while some research suggests that acid reflux surgery can improve asthma in some, there isn’t good evidence that antacids are effective in treating asthma, adds Dr. Ears added.
Kirsty was diagnosed with the disease aged 38 and given an inhaler containing the drug salbutamol, which improves breathing by relaxing the muscles in the airways
Occasional heartburn, usually accompanied by a burning pain for a few minutes when vomiting food, is quite normal and happens to many people at one time or another.
But it’s defined as GERD when symptoms become more persistent and bothersome and include severe reflux—which is problematic because it can lead to long-term complications.
Risk factors for GERD include obesity, pregnancy, and hiatal hernia, where part of the stomach protrudes beyond the diaphragm.
But Kirsty never suffered from acid reflux symptoms, so she assumed her doctor’s asthma diagnosis was correct.
Her problems began in 2008 with what appeared to be a cold.
But after Kirsty, a Nottingham property manager, shook off her ‘cold’, a persistent cough persisted.
“I couldn’t get rid of it and I was out of breath all the time,” she says.
Her family doctor prescribed antibiotics for a respiratory infection, but her symptoms were so bad that she was panting all the time and could only breathe when she stood up.
Further investigations followed because her GP suspected pleurisy (inflammation of tissue between the lining of the lungs and the chest). An X-ray was clear but showed a broken rib.
“It turns out that I threw it up from a bad cough,” she says.
Finally, after weeks of coughing and shortness of breath, her doctor diagnosed her with asthma. “He gave me the blue inhaler and told me to smoke it if I had to,” says Kirsty.
She went home and used it as prescribed for several months without any change.
But when a nurse examined her a year later, she had a peak flow test that called that diagnosis into question.
She recalls: “The nurse took one look at my results and said, ‘You don’t have asthma. Your peak flow is too good.'” I was worried.” She continued to suffer and returned to her GP in 2010, this time to a different doctor.
“I explained that I was still out of breath and that the asthma diagnosis must have been wrong because the inhaler did nothing to relieve the symptoms,” she says.
“This new family doctor listened to my symptoms and just said, ‘You have GERD.’ I had no idea what it was.’
Kirsty was referred to a gastroenterologist who performed an endoscopy, inserted a tube with a camera down her esophagus – and was officially diagnosed with GERD. But no treatment was offered to her after the diagnosis, and Kirsty had a constant cough for six years.
She eventually went back to her family doctor, who referred her for a barium swallow test (which examines the throat and esophagus while the patient swallows a liquid). It discovered chronic inflammation and revealed that Kirsty had severe GERD.
The doctor said it could have caused her shortness of breath.
Kirsty has been prescribed lansoprazole, a drug that will stop her stomach acid production. Within days of taking the pills, she began to feel better.
“A tightness I always felt in my waist disappeared,” she says. My shortness of breath has improved. I still coughed, but the feeling that I could never breathe properly disappeared.”
Kirsty, now 50, no longer uses her inhaler. “I’m still on PPIs, which have controlled my breathing, but I often get hoarse and cough a lot,” she says.
Dr. Hoare adds that while not everyone is going to have GERD, “if you’re diagnosed with asthma and you get heartburn, you have to think, why not treat my heartburn with a prescription antacid for a while and see if my asthma improves ?’.
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
