shortness of breath all the time

Three years ago I was aborad in Austria when I got a really bad cough. I ignored it for awhile and it finally went away. The thing is afterwards I started having shortness of breath all the time, 24/7. In all honesty, I am not in pain and it is not bad enough to be really noticed by others but it is annoying. I yawn and sigh so much to make up for it and every two minutes or so I need to take a really deep breath. Even when I take a deep breath sometimes it feels as if I didn't inhale it all the way. When I came back to the States my doctor sent me to a specialist to have a upper Gi Endoscopy done and they found a stomach ulcer (negative for H pylori). They put me on Nexium and told me the two were related but even though my heartburn went away the breathing thing remained. I even lost weight to see if that would help and it didn't. I am going back to the Gastro. specialist (different doctor) for another endoscopy to see if he can find something different. It is worse during exercise and at night. My friend, who is a LVN, told me it is asma, but can asma be 24/7? Also, you should note that I had a Peak Flow test done and it came out average. My doctor's also listened to my lungs and said they were great. One of them suggested anxiety but I am the most relaxed person I know, I feel that just because it is not that noticeable I am getting the brush off. Could what I thought was heartburn be related?

I also get those weird throat croaks or burp like behaviors all the time, starting right after my cough in Europe. It starts in my chest then goes half way up my thoart, then my body forces it back down. It's pretty embarassing sometimes because it makes noises. Could these be related?

Any advice is appreciated. I would like to go back to my doctors prepared with information. Thank you.

[National Jewish Health]

I believe there to be a good possibility that you do have asthma and that the asthma is largely responsible for your respiratory symptoms, very likely to be worsened by your upper gastrointestinal disease.  While it continues to be debated, many experts believe that the apparent association with gastroesophageal reflux disease (GERD) is cause and effect, and real.  It is very likely that the “throat croaks or burps” are a manifestation of GERD.

Not all asthma wheezes, and most asthma wheezes only part of the time, so it is possible that your lungs were clear when your doctor listened.  The only symptom of some people with asthma is cough.  Since one of your primary symptoms is shortness of breath, any further diagnostic evaluation should focus on that and the 2 main sources of shortness of breath being heart or lung disease; the third would be disorders of respiratory drive such as the hyperventilation syndrome and, should you see a lung specialist, you should inquire about that possibility.

There are a number of conditions that can mimic asthma, most notably vocal cord dysfunction (VCD), first described in 1993 and since determined to occur alone or in conjunction with asthma.  The diagnosis can be established by direct observation of one’s vocal cords and strongly suspected on the basis of abnormal pulmonary function tests (PFTs), specifically on the basis of an inspiratory flow volume loop.  You should have pulmonary function tests (PFTs) performed, before and after the administration of a bronchodilator, to assess the question of asthma and, if these are normal, your doctor may want to order a methacholine challenge, looking for evidence of asthma.

I believe you are being candid when you describe yourself as, “the most relaxed person I know”, but I suggest that you not entirely dismiss the possibility that anxiety or anxiety with panic disorder may be contributing to your problem.  Finally, I think it is wise of you to seek reevaluation by a gastroenterologist.  You may have reflux or you could have a disorder of esophageal motility.  You may want to share this message with your doctors.

Good luck.