WRITER: TANIA KLIVEN
CONTACT: DAVE PEDERSEN
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-8032; fax (319) 335-8034
Release: March 10, 1999
UI researchers look at role of acid reflux in non-cardiac chest pain,
IOWA CITY, Iowa -- For doctors, symptoms such as heartburn and regurgitation
usually make the diagnosis of gastroesophageal reflux (GERD) -- also known
as acid reflux -- fairly straightforward. However, doctors and researchers
believe there may be a stronger connection between GERD and other ailments
such as non-cardiac chest pain, laryngitis or hoarseness and non-allergic
In a review article published in the January 1999 issue of Postgraduate
Medicine, Satish Rao, M.D., associate professor in the UI department of
internal medicine, and Victor Mujica, M.D., a fellow in the department's
Division of Gastroenterology-Hepatology, detail the potential relationship
between GERD and these three ailments.
"By better understanding some of the atypical complaints, doctors
may more effectively treat these conditions," Rao said.
Previous studies have shown that patients with non-allergic asthma have
increased amounts of acid in their esophagus, which is believed to be the
cause of their asthmatic symptoms. But it is not clear how the excess acid
in the esophagus blocks the passage of air, which causes an asthmatic reaction.
One theory is that breathing in tiny gastric contents into the bronchial
tree may lead to pulmonary damage and cause asthma. However, this theory
remains unproven, Rao noted.
As for cardiac pain, many patients who believe they are having a heart
attack may actually be suffering from symptoms of GERD. According to Rao
"approximately 200,000 new cases are diagnosed each year for chest
pain in which the cause is not heart-related." Chest pain induced
by acid reflux may occur in patients with coronary artery disease or may
be brought on by medications that are used in the treatment of heart disease,
Similarly, Rao said that "in the general U.S. population there
is a high occurrence of hoarseness, sore throat, and chronic cough,"
which also suggests that there may be a relationship between such problems
While symptoms of GERD occur in only 20 to 40 percent of patients with
throat problems, the absence of GERD symptoms does not necessarily mean
there is no association between the two. A number of throat disorders have
been associated with acid reflux, including sinusitis and vocal nodules,
In many cases, treating GERD can improve non-allergic asthma, chest
pain or throat problems. Lifestyle modifications (avoiding certain spicy
foods as well as smoking and drinking, plus reducing dietary fat and meal
size), antacids or anti-reflux surgery can be effective. However, since
GERD is a chronic problem, medical treatment may continue throughout a
"It is important to see a gastroenterologist, particularly if an
individual is over age 45 and has persistent symptoms or other health risks
such as smoking, obesity, sedentary lifestyle and excessive ingestion of
antacids," Rao said.