Acid reflux, the backward flow of stomach acid also known as gastroesophageal reflux disease (GERD), is a common condition in adults and infants. In fact, as many as 60 to 70 percent of babies between 3 and 4 months old experience infant reflux. Pulmonary symptoms include spitting up frequently and coughing, and there is also a long-established link of infants with eczema being more prone to acid reflux. This condition is rarely serious, and not usually cause for concern in an otherwise healthy baby. Many babies simply outgrow the condition.
Melodi B. Pirzada, MD, chief of the Division of Pediatric Pulmonology at NYU Winthrop Hospital, noticed an interesting pattern as she treated infant pulmonary conditions over the years. Dr. Pirzada often receives referrals from pediatricians who have diagnosed infant patients as having asthma, with symptoms including spitting up and wheezing. Dr. Pirzada treated these patients for infant reflux since they were spitting up, and when their wheezing symptoms also improved she began to wonder if they actually had asthma.
Dr. Pirzada, together with Farah Deshmukh, MD, and Endy A. Dominguez Silveyra, MD, began to analyze the topic in more depth. “We hypothesized that young patients were being overdiagnosed with asthma when they might actually just be suffering from reflux,” Dr. Pirzada explains. After a review of over 260 subject cases of infant reflux, their analysis showed that more than 50 percent of the cases included pulmonary symptoms, usually a cough, and the incidences of these symptoms rose to 84 percent in infants that also had eczema. Of note, these patients with pulmonary symptoms also went on to have higher rates of early-onset asthma at a median age of 8.4 months old.
“If a child has reflux, it doesn’t mean they will go on to have asthma,” says Dr. Pirzada, “But if a child has reflux and eczema, our findings point to that infant being more prone to early-onset asthma.”
Dr. Pirzada adds that while the findings are not fully conclusive, an NYU Winthrop follow-up study is now tracking the number of reflux and eczema patients who develop asthma or simply outgrow the reflux.
“What’s most important to consider, is that GERD should be diagnosed and managed as early as possible to prevent potential long-term pulmonary complications,” says Dr. Pirzada. “Our promising research may lead us to better diagnose the risks of asthma in many young patients, allowing us to take precautions to avoid triggering that chronic condition that can last a lifetime.”