Gastroesophageal reflux disease, or GERD, can trigger asthma attacks in some people. Reflux occurs when stomach acids splash or leak upwards into your esophagus. Many people have reflux without noticing heartburn or other symptoms in the esophagus. For this reason, asthma may be the only symptom of reflux.

Researchers have identified two separate ways by which acid reflux may aggravate asthma. When acid is present in the lower esophagus, it can trigger a nerve reflex involving the vagus nerve. Acid is detected by receptors in the cells that line the esophagus, nerves are triggered to send signals, and the end result is tightening of the muscles of the airways. Many experts feel that this nerve reflex is the major reason that acid problems can result in asthma. The other way gastroesophageal reflux may trigger asthma is by directly exposing the upper bronchial tubes to small amounts of acid, if acid refluxes vigorously enough to reach the throat and upper airways. Acid in the upper bronchial tubes is irritating to the airways and causes them to constrict.

Acid reflux is most active while you're lying down or asleep, especially after a big meal. This may result in a pattern of asthma that is most active at night, if reflux is one of your asthma triggers.

Here's how to prevent reflux-related asthma:

• Include an antacid drug as one of your asthma treatments. If reflux is identified as one of your asthma triggers, then your reflux should be treated aggressively. You may need daily antacid medication to help keep your asthma in good control.
  
  
• Eat your dinner well ahead of bed. Going to sleep on a full stomach increases the likelihood you will have nighttime reflux. It is best if you can avoid eating for at least two hours before you lay down in bed.
  
  
• Raise your bed. If you have GERD, elevate the head of your bed by placing blocks of wood underneath the headboard posts. Gravity helps prevent reflux.
  
  
• Consider your medicines. Theophylline medications, which are sometimes prescribed to help control asthma symptoms, may actually loosen the muscular sphincter at the bottom of the esophagus and can aggravate reflux. If you have frequent heartburn, these medicines may cause more trouble than good. Talk with your doctor about alternatives.
  
  
• Learn your heartburn triggers. Foods that cause heartburn often translate into nighttime stomach reflux that can trigger asthma attacks. Things in your diet that can relax the lower esophageal sphincter and provoke reflux include chocolate, coffee and other caffeinated products, peppermint, fatty foods and alcohol. Smoking is also a trigger.