I fought with this very issue all of last year. It can really be scary. I even posted a thread last year on aspirating acid. Never got much feedback. Don't think there are a lot of us out there with this problem because it is pretty rare.
Because you hit on a topic I'm passionate about, this answer will be kind of long. I hope it helps.
My initial answer for you is generally no. You won't die from inhaling the acid from reflux. That said, I had a scary incident myself and it really is serious and needs to be aggressively treated. If you don't take care, it could land you in the hospital. If you seek help for your problem now and are good on your follow-through, it is treatable and you should be OK.
My LPR reflux symptom was a chronic cough. I was able to control it with twice a day PPI's and asthma meds. (I do have asthma also.) Honestly, I couldn't tell when the cough was just asthma and when it was reflux acting up.
I had an incident in January 2008 where I need emergency care for my asthma. I couldn't get a good breath, couldn't speak two words in a row, had my lips and fingers turn purple and become tingly, became lightheaded and started hyperventilating. They treated me for the serious asthma attack and sent me on my way. At that point, I decided to self-refer to a Pulmonologist to see what was really going on. My strong daily preventative meds and Albuterol really weren't cutting it. It took 4 months of PCP visits and waiting for my Pulmonary appointment.
My Pulmonologist spent over 1/2 hour talking to me when I first went in. I went away with an asthma plan and the instructions for some testing. I had a Pulmonary Function Test and a Modified Barium Swallow & Esophagram. It was the latter that really opened my eyes. My Pulmonologist called me on a Sunday afternoon to tell me I wouldn't ever get my breathing problems under control until my "swallowing disorder" was under control. I told him I didn't have a swallowing disorder. He told me I did. I told him I didn't feel symptoms of a swallowing disorder. He told me I did. Up to that point, I had never heard of reflux as a swallowing disorder. Apparently the Barium testing confirmed that I had acid coming up and irritating my lungs. I was also aspirating small amounts of the acid. The irritation caused my coughing and also triggered my asthma. That is what caused my emergency asthma attack and chronic coughing and shortness of breath. Honestly my quality of life at that point was pretty poor because my breathing and coughing got so bad.
My next step was to go back to my Gastroenterologist. I was already on twice a day PPI's and had already made lifestyle changes. I ended up spending the summer trying a new PPI every month to try to get the reflux under control. That works for most people, it didn't for me. I had some reflux testing and even on a good day, my reflux showed as extremely severe. The good news was that I didn't have any esophageal damage, the bad news was that my reflux was getting worse. (This was my second time around for the testing.) Eventually I opted for the surgical route--per my Pulmonologist, GI doc, ENT and surgeon. That was my "miracle" solution, alabet an extreme one.
On my follow-up Pulmonary appointment, my Pulmonologist told me that he had just come from the bedside of someone with my same problem and symptoms. He indicated that if I hadn't been as aggressive in my own treatment and follow-through that I could have been the one in that hospital bed. Because I was aggressive in getting treatment and diligent in my follow-through, I was able to get things under control. Now my only asthma attacks are environmentally related only. My post-surgical PFT's and lung x-rays were all normal and didn't show any damage, even after over a year of bad symptoms.
My advice based upon experience, doctors visits and research:
- Don't stress too much. Respiratory problems with reflux are rare. Stress can make your reflux worse. That burning you feel when you aspirate the acid probably won't do much on its own if it happens infrequently. It's just very uncomfortable. It is when it affects your breathing or is happening more frequently that it is more serious, especially in the long-term.
- Visit a Pulmonologist and a Gastroenterologist. They can determine if there is any damage and get you on a treatment plan that is right for you. If you think it is a serious problem, ask about the Barium testing and 24 hr pH testing. Don't just rely on your PCP for treatment.
- Be aggressive in your own treatment. This includes reading up on reflux, watching your diet, making lifestyle changes and developing a treatment plan with your doctors.
I hope I didn't scare you with this e-mail. I want you to know there are others out there with this problem. I also want you to take things seriously now before it gets worse. I wouldn't worry as much about damage if you haven't had this problem frequently. I had my severe reflux for years and have no acid damage. It may take a while to find treatment regimines that work for you, but keep at it and you can get things under control. I had mine under control for years until my problems last year.