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Undiagnosed breathing problem 24yr old
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Undiagnosed breathing problem 24yr old

I am a 24 year old male. I started to develop breathing problems about 1 year ago.  My problem is I feel like it’s hard to breathe. I can inhale good and exhale good, but I get a dull feeling in my chest once I exhale all the way, it kind of feels like the feeling when you hold you breathe for a long time. It comes and goes, when it happens it last for hours or days.  

I have had a EKG, a chest x-ray, a pulm function test with and without dilators (and all the max-rymthic tests), and a barium swallow test. All very good results, except I have a very small sliding hitial hernia. I did smoke for 5 years, but I quit more than a year ago and intensely exercise 6 days a week.

I am on Nexium 40 mg a day for heartburn, but I had this problem before I started taking it. I do get reflux, have been on the pill for 40 days, and seems to help the reflux. Any ideas on my breathing problem? Could it be something in my throat? My primary doc, says maybe get endoscopie, but he said that would look for a peptic ulcer or a ring in my esopogas. Now, the barium swallow looked good, except the small hernia. He said something about pressure from the esopougas to the lungs? I don’t know doesn’t sound right.  I do get a burning feeling from my lower chest when it happens sometimes (hitial hernina area), and sometimes my lungs feel like they are hot (or could be same hitial hernia area)..hard to tell.  I do not have a reg cough. Just the normal occasional cough that everyone had. (ie. I do not cough regualry, which is good) They tried me on a inhaler before the puml. function tests, no help, and was told to discontinue after test. Besides that, I am generally healthy. I just went about 2 weeks with no symotons, then it came back today. I did have refulx after eating general tso's chicken last night, I did eat too much, and forgot my nexium this morning. But I dont see how reflux could cause breathing discomfort. Any ideas? reflux? something else?

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The normal/negative test results are quite reassuring, as they rule out a fair number of serious diseases.  Unfortunately, gastroesophageal reflux disease (GERD), commonly called acid reflux, can cause reflex bronchospasm, even when the extent of the reflux is limited to your esophagus and does not result in aspiration of gastric contents into your lungs.  That, despite the Nexium® (esomeprazole), might still be your problem.  For that reason and because of the limited sensitivity of a barium swallow, upper endoscopy might well be a good idea, as might testing for abnormalities of esophageal motility.

The source of your symptoms could thus be gastrointestinal, pulmonary or cardiac, although the “max-rhythmic” tests, the EKG and your capacity for high level exercise would probably rule out a cardiac cause.

Your symptoms could also be due to anxiety, the result of sustained and/or intense stress.

Good luck.
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