acid v smoking lung damage

[withie]

I was just wondering if you could tell me to what extent acid can damage the lungs when aspirration takes place.
I am a bit confused my pft came back with abnormal results not majorly so but enough to indicate mild emphysema/asthma, as stated in a previous posting my achalasia and acid reflux was really active at the time this was carried out.  Niaively I did not realise that having acid affects ones breathing which is why the pft was carried out I was sob.  So I got to thinking as I am only a light smoker 8-10 per day for 28 years (now stopped) and the sob only started when my achalasia dilation was due to be redone and a lot of acid is going into my throat causing hoarseness and breathlessness was this the cause?  So what sort of damage is actually done to the lung by acid aspiration is it the same sort of damage as smoking.  This gets more complicated as one consultant tells me it could be the acid which has caused the abnormal pft results but  my cardiologist tells me that although acid damages the lungs the he thinks it will be the smoking.  I need to sort this for myself.  Do you know if there is any sort of test of function which will let me know what has done the damage to my lungs. Indeed do you know the difference in damage to the lungs between smoking and acid.  Thankyou so much Withie.

[National Jewish]

There are no tests that would allow for a calculation of the relative impact of smoking vs. that of acid reflux with aspiration.  The question is relatively academic, as complete, lasting smoking cessation and optimum medical and surgical measures to prevent/reduce the amount of reflux/aspiration should be pursued no matter which of the 2 may have caused more damage.  Given that your pulmonary function tests (PFTs) were done during an unstable period, they should probably be repeated when your achalasia is stabilized.  However, if the results are normal or nearly so, do not assume that you can resume smoking, even a few cigarettes daily, with impunity.