Acid Reflux Signs And Symptoms
Q: I'm a middle aged male who developed asthma about 9 years ago after a bout of severe bronchitis. My
pulmonist has me on Azmacort 6 puffs 2x a day.
I also have Proventil as needed. I use prednisone only when I get
my occasional bronchitis....usually 3 days after a cold sets in. The
current treatment plan is working well. However I hear that Intal is a
very safe drug with 0 side effects and works well for exercise
induced asthma. I was on it early on into the start of my asthma. It
seemed to have no effect. My question is : has anyone had good
results with Intal? Should I discuss with my dr the possibility of lowering
the inhaled steroid and using the intal with it. I'm concerned of the side
effects of the steroids. A story I will share with you. When I get
bronchitis I take prednisone...60 mgs 2 days...
then taper 10 mg a day. After using this med I noticed at night a glare
from cars. I went to my opthamologist and they found what
looked like a hard crystalline spot on the lense of my eye. Very
small, yet irratating. From the steroid? Maybe? It's not what they
would say is your normal cataract either. I know the inhaled
corti-steroids are relatively safe but I would like to cut down the use of
them. Any suggestions out there? The Intal? Mixed with Azmacort?
A:Intal is a tool used to prevent the full blown asthma response
in exercise induced and other forms of asthma. It works for some and not for
others.The same can be said for "leuks" like Accolade or Singulair.
When I trained, we were taught that EIA was caused by a cold air
trigger response which occurred during exercise ( mouth open- breathing
deeply with fast gas flow ). This still has merit.
At our center, we have noticed acid reflux occurring in some patients during
exercise as well. One patient was a 8 year old girl.
We had them use anti-reflux measures and they observed a great relief
from EIA signs and symptoms.
There is little in the literature to support this, but I have to remind myself
that empiricism plays a huge role in medicine.
Do you have heartburn, chest tightness, bubbling sensation or acid test
ever? Night time awakenings with choking/coughing?
Some physicans only resort to prednisone if doubling the dosage of inhaled
steroids fails after 1-3 days. It generally take 24 hours for peak flow
monitoring to reflect an increase in inhaled or oral steroids.
Are you monitoring peak flows and kepping an asthma diary to correlate
signs with peak flows and medication dosages?
If you are not using one, a spacer device should be used for administering
your inhalers.
Spacers (such as Aerochamber, Ventahaler etc )have 2 functions:
1. To reduce oropharyngeal deposition of large particles
When you puff your inhaler, a mixture of large and small particles
are administered. Only the small particles get into the small airways,
the large particles end up in the mouth and throat.
The spacer device filters out a lot of the large particles and with
routine use should get a white coating which tells you it is filtering.
The big particles