Acid reflux occurs when acid leaks from the stomach back up into the esophagus. An occasional bout of acid reflux is generally not a cause for concern. However, a frequent pattern of acid reflux may be a sign of gastroesophageal reflux disease, which is a chronic digestive issue that can cause medical complications.

Sometimes, acid reflux occurs together with shortness of breath. In some cases, acid reflux causes shortness of breath.

People who have gastroesophageal reflux disease (GERD) may be at increased risk of have asthma or other respiratory conditions.

This article describes the link between acid reflux and shortness of breath, outlines some of the symptoms of acid reflux, and looks at the treatment options available.

What is the link between these symptoms?
Acid reflux occurs when acid leaks up from the stomach back up into the esophagus. When this happens, the acid can irritate the airways, causing them to swell. This can result in breathing difficulties.

The link between GERD and asthma

Acid reflux and shortness of breath can often occur together.
Researchers have also identified a link between GERD and asthma. A 2019 study suggested a bidirectional relationship between GERD and asthma. This means that people with GERD may be more likely to have asthma, and people with asthma may be more likely to experience GERD.

In fact, a 2015 study estimates that up to 89% of people with asthma also experience GERD symptoms. The reason for this may be due to how acid interacts with the airways. Acid in the esophagus sends a warning signal to the brain, which triggers the airways to contract. This, in turn, triggers asthma symptoms.

In cases of GERD-related asthma, treating the symptoms of GERD may help alleviate the symptoms of asthma.

As a 2016 review notes, asthma may also trigger GERD. During an asthma attack, the airways tighten, causing pressure in the esophagus. This increased pressure could encourage acid to leak into the esophagus.

Sometimes, it may be difficult to tell whether a person’s symptoms are the result of asthma or GERD. For instance, a 2015 case study notes that typical GERD symptoms, such as burping and shortness of breath, may sometimes be signs of asthma. The authors of this study emphasize the importance of a thorough diagnosis in each case.

Other symptoms of acid reflux
A person experiencing acid reflux or GERD will likely experience additional symptoms, such as:

regurgitation, which is where acid comes back up into the mouth, causing a burning sensation and a sour taste
heartburn
indigestion
chest pain
wheezing
stomach discomfort
persistent hiccups
bloating
burping
difficulty swallowing
sore throat
bad breath
People with GERD-related asthma symptoms may also notice that their breathing difficulties flare up at certain times. Often, this occurs during sleep or after eating a large meal.

Complications
Untreated or unmanaged GERD can lead to numerous health complications. Some examples include:

Tooth decay
GERD symptoms may cause partially digested food and acid to leak back up into the mouth. The acid can come into contact with the teeth, increasing the risk of tooth decay.

Esophageal ulcers
Sometimes, acid can wear through the lining of the esophagus, causing ulcers.

Esophageal ulcers may cause the person to spit up blood or pass blood in their stool.

Respiratory complications
Accidental inhalation of stomach acid into the airways (called aspiration) can worsen respiratory conditions such as asthma or lead to pneumonia.

Throat and voice problems
Long-term exposure to stomach acid may lead to a sore throat or changes in a person’s voice.

Esophageal inflammation
Acid that backs up into the esophagus may cause inflammation of the esophagus. Doctors refer to this as “esophagitis.”

Esophagitis can be painful and may lead to scarring of the esophagus.

Stricture
Over time, chronic inflammation of the esophagus can lead to a build-up of scar tissue and narrowing of the esophagus called a “stricture.”

A person who has a stricture may experience pain or difficulty when swallowing.

Barrett’s esophagus
People who experience persistent GERD are at increased risk of developing Barrett’s esophagus. This is where the tissue in the esophagus begins to resemble tissue in the small intestine.

Some people with Barrett’s esophagus will go on to develop esophageal cancer.

Esophageal cancer
People who experience severe and persistent GERD are at increased risk of developing esophageal cancer.

Treatment for esophageal cancer is much more effective If a person begins treatment in the earlier stages of the disease.

Symptoms of esophageal cancer include:

chest pain
chronic cough
difficulty swallowing (which may progress from difficulty swallowing solids to liquids)
weight loss
bleeding into the esophagus
bone pain (if the cancer has spread to bones)
hoarseness
Treatment
Lifestyle and dietary changes are typically the first line treatment for GERD symptoms, such as acid reflux and shortness of breath. If these treatment options are not effective, a doctor may prescribe medication to manage GERD symptoms.

Lifestyle changes
Some lifestyle changes that may alleviate GERD symptoms include:

achieving and maintaining a healthy weight
quitting smoking
avoiding laying down within 3 or 4 hours of eating a full meal
elevating the head slightly while sleeping, which may help to reduce night-time acid reflux
sleeping in a comfortable position that keeps the body aligned
avoiding tight clothing, belts, or accessories that put pressure on the abdomen
Dietary changes
The following dietary changes may also help to alleviate GERD symptoms:

identifying and avoiding personal food triggers for GERD, such as citrus, or other acidic foods
reducing alcohol consumption or avoiding alcohol completely
eating smaller, more frequent meals, instead of large meals
avoiding eating near bedtime
Medical treatment
The following drugs may help to suppress acid reflux and prevent complications from GERD:

over-the-counter (OTC) or prescription-strength antacids
proton pump inhibitors
H2 receptor blockers
When to see a doctor
A one-off or occasional bout of acid reflux and shortness of breath may not be cause for concern. If a person can keep the symptoms at bay using OTC medications, there is generally no need to see a doctor.

However, anyone experiencing persistent acid reflux or GERD symptoms should see a doctor for a full diagnosis. A doctor may carry out diagnostic tests to determine the cause of GERD and to identify any possible complications. A doctor may also prescribe medication to help manage GERD symptoms.

Summary
A one-off or occasional bout of acid reflux and shortness of breath is rarely cause for concern. However, anyone who frequently experiences this combination of symptoms may have gastroesophageal reflux disease (GERD) or asthma. They should see a doctor for a full diagnosis.

People who experience GERD symptoms may benefit from certain lifestyle and dietary changes. Some people may require medication. Early treatment may help to prevent complications from GERD.