How does reflux cause shortness of breath?

Reflux is a common condition that can cause a variety of uncomfortable symptoms ranging from heartburn to coughing. One of the lesser-known symptoms of reflux is shortness of breath.

In this article, we will delve into how reflux causes shortness of breath, its symptoms, diagnosis, and ways to manage it effectively.

Symptoms of Reflux

Gastroesophageal reflux disease (GERD) is a chronic condition affecting the digestive system. The most common symptom of GERD is heartburn, which is characterized by a burning sensation in the chest that often occurs after eating, lying down, or bending over.

However, not everyone with GERD experiences heartburn. Instead, they may exhibit other symptoms such as:

  • Chest pain
  • Bloating
  • Burping
  • Nausea
  • Sore throat
  • Bad breath
  • Coughing or wheezing
  • Difficulty swallowing
  • Shortness of breath

The last symptom, shortness of breath, is often overlooked as a sign of GERD. However, it is crucial to recognize this symptom because it can have severe consequences if left untreated.

How Does Reflux Cause Shortness of Breath?

Reflux can cause shortness of breath in several ways. The two most common ways are:

The Acid Reflux-Asthma Connection

Studies have found a significant association between acid reflux and asthma. Acid reflux occurs when stomach acid flows back into the esophagus, causing irritation and inflammation. If the acid reaches the lungs, it can trigger or worsen asthma symptoms.

Asthma is a chronic condition that affects the airways, making it difficult to breathe. The symptoms of asthma include:

  • Wheezing
  • Coughing
  • Shortness of breath
  • Chest tightness

Reflux can exacerbate these symptoms by causing a hypersensitive reaction in the airways. This hypersensitivity can cause the muscles in the airways to constrict, making it difficult to breathe.

The Vagus Nerve Connection

The vagus nerve is a long nerve that connects the brain to the digestive system. It plays a vital role in regulating breathing and swallowing, among other functions.

When the vagus nerve is stimulated by reflux, it can cause the airways to narrow, leading to shortness of breath. This narrowing can be severe enough to cause wheezing and coughing, mimicking asthma symptoms.

Diagnosis of Reflux-Induced Shortness of Breath

Diagnosing reflux-induced shortness of breath can be challenging because the symptoms can mimic those of other conditions such as asthma, chronic obstructive pulmonary disease (COPD), and heart disease.

Your doctor may begin by taking a detailed medical history and performing a physical examination. They may also order one or more of the following tests:

  • Endoscopy: A thin, flexible tube with a camera is inserted through the mouth to examine the esophagus and stomach for signs of irritation or inflammation.
  • Esophageal pH monitoring: A small device is inserted through the nose into the esophagus to measure the amount of acid in the lower esophagus over 24 hours.
  • Pulmonary function tests: You will be asked to breathe into a machine that measures how well your lungs are functioning.
  • High-resolution CT scan: This test uses X-rays and computer technology to create detailed images of the lungs and other structures.
  • Stress test: This measures how well your heart and lungs function during physical activity.

These tests can help determine the cause of your shortness of breath and help your doctor develop an effective treatment plan.

Treatment Options for Reflux-Induced Shortness of Breath

Once you have been diagnosed with reflux-induced shortness of breath, your doctor will recommend an appropriate treatment plan. Here are a few options:

Lifestyle Changes

The first line of treatment for GERD is making lifestyle changes such as:

  • Eating a healthy diet
  • Avoiding trigger foods such as spicy, fatty, or acidic foods
  • Stopping smoking
  • Losing weight if you are overweight or obese
  • Wearing loose-fitting clothing
  • Sleeping at an angle (with your head elevated)

These measures can help prevent or reduce reflux symptoms, which, in turn, can alleviate shortness of breath.


If lifestyle changes alone do not relieve your symptoms, your doctor may recommend medications such as:

  • Antacids: These neutralize stomach acid and can provide fast relief from symptoms such as heartburn.
  • H2 blockers: These reduce the amount of acid that the stomach produces and can provide long-term relief.
  • Proton pump inhibitors (PPIs): These are the most potent acid blockers and can provide long-term relief from symptoms.

Your doctor will recommend the medication that is right for you, depending on the severity of your symptoms and other factors such as your age and overall health.


In severe cases of GERD, surgery may be necessary. The most common surgery for GERD is fundoplication, which involves wrapping the top of the stomach around the esophagus to create a tighter seal that prevents reflux from occurring.


Reflux-induced shortness of breath can be a challenging condition to diagnose and treat. However, by following a combination of lifestyle changes, medications, and surgery, you can effectively manage your symptoms and live a healthy life.


Here are some frequently asked questions about reflux-induced shortness of breath:

  • Can reflux cause breathing problems?
  • Yes, reflux can cause breathing problems such as shortness of breath, wheezing, and coughing. These symptoms are often overlooked but can be severe enough to mimic asthma.

  • How is reflux-induced shortness of breath diagnosed?
  • Reflux-induced shortness of breath is diagnosed through a series of tests that may include endoscopy, esophageal pH monitoring, pulmonary function tests, high-resolution CT scan, and stress tests.

  • What is the best treatment for reflux-induced shortness of breath?
  • The treatment for reflux-induced shortness of breath includes lifestyle changes such as diet modifications, avoiding trigger foods, and sleeping at an angle. Medications such as antacids, H2 blockers, and PPIs can also help. In severe cases, surgery may be necessary.


  • Guleria, R., Jaques, P. F., & Pinto Lopes, A. (2019). Reflux-Induced Asthma and Cough. In Breath Sounds (pp. 29-39). Springer, Cham.
  • Kahrilas, P. J. (2008). Gastroesophageal reflux disease. New England Journal of Medicine, 359(16), 1700-1707.
  • Kim, Y. H., Lee, J. H., & Kim, J. H. (2019). Clinical significance of gastroesophageal reflux symptoms in patients with bronchial asthma. Korean journal of internal medicine, 34(6), 1289-1299.