It is often difficult to know if reflux causes lung problems or if it is the other way around. Since the windpipe (trachea) and the esophagus are very close together, many people have assumed that aspiration of the refluxed stomach contents leads to respiratory symptoms.

Reflux of stomach contents up into the upper esophagus has been shown in children with recurrent respiratory symptoms, however this appears to be uncommon and is probably rare among children who are neurologically normal.

While children with neurological abnormalities may aspirate reflux, it is more common for them to aspirate while they are eating, called laryngeal penetration and occurs when swallow-breathe patterns are not well coordinated. Normally when swallowing there is a pause in breathing and the larynx closes t protect the airway. In children with no swallowing difficulties it is believed that they will not aspirate while refluxing.

There are reports of children who suffer from chronic congestion and chronic hoarseness having reflux. It is thought that aspiration of reflux causes inflammation and swelling of the upper airways and results in noisy breathing (stridor) or spasms of the vocal cords (larynogospasm).

The role of reflux in apnea (stopping breathing) and bradycardia (slowing of the heart rate) is being studied because of potentially life-threatening situations. So far reflux has not clearly been demonstrated to cause apnea. It is thought to be coincidental though in extremely rare ocassions there is thought that reflux has caused this.

If you see your child having difficulties breathing this is extremely serious. Your child may choke and turn dark red then purple. First pick the child up and pat them on the back. If this does not clear it up, then grab a bulb syringe and aspirate the nasal cavities. The most successful way of doing this is to close one nostril while aspirating the other. If you see your child turn blue (this may be while the child is sleeping) immediately stimulate the child by picking them up. If this does not stimulate them and you are sure they are not breathing, you may need to perform infant CPR. You will want to call 911 IMMEDIATELY if an episode like this occurs. If your child has a history of Apnea, Bradycardia or Aspiration it is very important that you take an infant CPR course. You just never know when you'll need it. If you even suspect this could be happening contact your pediatrician immediately. These events can potentially be life-threatening.

There are tests that can confirm Apnea/Bradycardia, such as a Sleep Study. In a sleep study your child is connected through a series of wires (painless) to a machine which records their breathing, heartrate, blood oxygen saturation and in some cases brain waves. For Aspiration, a swallow study may be ordered to confirm the diagnosis. This is a simple, non-invasive procedure where different textures of food from juice to solids are given to the child mixed with barium and a technician watches on a machine as they eat/drink. For more information on these and other tests visit the testing section of this site.

Both children and adults with chronic asthma have an increased incidence of reflux. But, it is not known which is the cause. Asthma may precipitate reflux since it may increase abdominal pressure which pushes stomach contents upward. Among children with chronic asthma, the percent of children with chronic ashtema the incidence of reflux has been reported to be between 46 and 75%. In adults the percentage has been as high as 82%. Few children have been reported with having improved asthma symptoms after being treated for reflux which means reflux should be considered a possible cause of uncontrolled chronic respiratory symptoms in children. Many of the things that trigger one also trigger the other.

See Also:

Our Asthma and Apnea Information Page.