I'll Be Eternally Grateful for an Answer (Thanks!!)

[LowMac]

Dear MedHelp Topic Dr. and fellow members (I'm a longtime member - haven't posted in a while).

Doctor (please forgive the lengthiness of this), I have undergone many tests in hopes of finding a cause for my symptoms. I had a spirometry exactly a year ago. No evidence of restrictive or obstructive lung disease (hallelujah!) but it was noted that I had some curvature indicating "minimal upper airway disease". It certainly doesn't feel minimal and I'm concerned about having or developing a type of chronic bronchitis. I'm a non-smoker but was around 2nd hand smoke from birth, to age 20 (my mother smoked but my dad did not). I'm now age 50.

My Symptoms: Constant need to clear throat-mucous, especially mornings and after eating. Yes I do have moderate esophagitis and moderate gastritis, plus a 'mild' hiatus hernia (diagnosed via upper endoscopy, very recently). My Gastroenterologist, was very unclear as to whether or not my GERD is causing me the athma type symptoms. I will add that I have an upper airway irritation (mild hurting) when breathing deeply and/or an urge to cough with deep breaths -- like a chest cold but this can go away the same day I feel it!! I'm thinking it is relieved once I clear my throat repeatedly, as if it clears the irritated airway (I don't suffer any sinusitis). I'm treated for asthma and GERD but the symptoms persist -- also working on losing weight (high-moderate but not severe obesity).

My question: Can my moderate esophageal inflammation be a cause for this and is there probability for it to turn into a type of COPD (chronic bronchitis)?

(FINAL NOTE: I do not cough up mucous/phlegm but the need to do strong throat-clearing, causes further throat irritation, horse voice. No rattle sounds of mucous deeper in my chest. The throat clearing can be fatiguing! I do get mild to moderate bronchospasm from this, like asthma.)

[LowMac]

Thank you -- I actually already did that and I was answered by "Dr. Tinkelman" there. His answer was also greatly appreciated.

[ChitChatNine]

Also, you can ask your question on our Ask an Expert forum:
http://www.medhelp.org/forums/Respiratory-Disorders/show/61

Where a doctor from National Jewish will respond.  It's a free forum!

C~

[LowMac]

Tammy,

Thank you for your advice. My Gastroenterologist is already convinced of my having GERD and that it has resulted in moderate esophagitis. I was placed on presciption strenght omeprozole for it. I think though that he and his PA who talked to me, were neither one convinced that the GERD was causing my asthma symproms. This almost seemed like denying the obvious to me because eating often flares the symptoms.

I think your mention of food allergies is an important one because certain things do affect my breathing very noticably. Like drinking coffee a couple of times or more in a row (sometimes even once), causes the acidicness of it to bring on my shortness of breath symptoms. Same is true of peanutbutter. I tested negative a few years ago for major food allergies (peanuts, eggs, dairy) however, I think I have intolerances to some of them and so it might as well be an allergy.

I will do more testing by elimination diet of these, to see if I see improvement. I do wonder though, with my having the constant phlegm production at times, if this can mean serious upper airway damage (I also know that spirometry doesn't always pick up on asthma, even with confirming or ruling out immediately present COPD).

I didn't mention in my first post, though should have, since the forum Dr. will probably read only that one, that I also commonly hear crackling and popping sounds coming from my throat. It's related to the mucous and not crackling like people have with pulmonary fibrosis, which is not mucous but rather from dry lung tissue. Besides the type caused by fibrosis, can only be heard in the lower lung quadrants via stethoscope (mine come & go and change, unlike fibrosis sounds, which are always there).

Still, the constant mucous sounds are concerning because it makes me wonder if serious damage has already occurred. I actually use a fan at night for noise, to keep from hearing it because I mouth breathe due to dry rhinitis -- my nasal passages stay very tight. They're small noises of course but hard not to concentrate on them, when you know they're happening.

Thanks again.

[Tammy2009]

It could be the GERD causing problems - have you done a 24 pH monitoring or impedenance test?  It tests for reflux (impedenance tests for both acidic and non-acidic reflux) - you write down the times you have symptoms and they upload the results to see if they correlate.

Allergies can also cause widespread inflammation - especially food allergies.  You could try eliminating the common food allergens for a couple weeks and see how you feel.