Breathing Issues

Since Nov 27th 2012 I've had breathing complications to the efefct of shortness of breath, tightness of the chest and asthma. On the date of 11/27/12 I had severe cold and took Nyquil since I hadn't slept in 2 days. As a result of this I ended up taking some Afrin in addition and within 10min of doing so I had a panic attack and shortness of breath and rushed to the ER. A CT Scan of the chest with an infusion was done and blood was drawn to rule out heart blockage or a potential blood clot. All results ruled everything normal with the mention of a slightly enlarged heart. I was told to take allergy medicine and get some rest. Well weeks later the chest tighness was reduced but still present so I decided to follow-up with my primary care physician. I'm a very fit person I workout 6 days a week consisting of minimal 2mile run each day max 5miles and do weight training 4 to 5 days a week. I drink tons of water and eat very healthy fruits, vegetables etc... I'm 34 yrs old and never had an existing health issue prior to this. Over the last few years my sinus issues have gotten progressively worse during the winter becaus ethe weather here in Houston TX is hot and cold every other day making the flu and cold season pivital. So fast forward between 11/27/12 and now I've seen each of these types of physicians (Primary Doc, Pulmonologist, Cardiologist, ENT and Gastro physician) 2 weeks ago and each has done their own respective study and nothing has resulted in identifying teh root cause or what the issue is. I can say that my sinus problem was fixed about 3 weeks ago after a CT Scan of teh brain resulted in the finding that I had a deviated septum and which the ENT resolved by performing a reduction of the turbinates. My breathings gotten better but the chest tightness still remains and as of 2 weeks ago I've started developing acid reflux like symptoms with junk feeling stuck in teh back of the throat, heartburn every now and then and the feeling of air or gas coming up teh esophagus when I sleep at night with my head elevated. I'm currently taking Omeprazole Cap 40mg and Ranitidin 300mg to try and resolve the reflux issue but I'm not feeling much difference. I was wondering can the descriptions Ive given all be a result of acid reflux or was it possible the sinus issues have started all of these problems. By the way the mention of teh enlarged heart showed negative when I saw the cardiologist as he stated the heart size and wall were within normal regions, I dont have high blood pressure or cholesteral and when I try woring out now I will feel pain in the cente rof my chest and middle or upper region of my back. I just started seeing the GI doctor 2 weeks ago and I've physically seen him once as this is my lastest attempt to figure the issue out. I was also told I might have asthma but all the medication given to treat that has made the issues worse so I've not taken any of those meds in over 5 weeks. Someone please help with any suggestions or possible things to look for. This has now been going on over 2months and it's very frustrating knowing all the test I've had done haven't showen or identified any causes. I'm hoping to get an endoscopy done to ensure the esophogus is normal.

[selmaS]

  Hi and welcome to the GERD forum.

It sounds like u r on the right track, the endoscopy should help figure out where the root of this lies....

In the meantime since u have reflux symptoms u will want to avoid foods and bevs that trigger the symptoms....acidic foods, greasy, spicy. carbonated, caffeinated...keep a journal to see what ur triggers r...as we all can be a little different ...look to the health Pages for tips on lifestyle changes u should make as well.

http://www.medhelp.org/health_pages/list?cid=236

[jdub2903]

Thanks for the reply. Does this also play a factor in working out and excersises because Im not able to do as intense of a workout at the moment as I was doing prior to getting sick if you can call it that because when lifting heavier weights or pushing my cardio to more extreme limits my chest gets tight and breathing is more difficult causing me to have to stop or slow the workout down. How does acid reflux factor in to all of this? Since my origional post I had a Methacoline Challenge Test completed to rule out athma and I passed that with no issues.

[selmaS]

  U may have a sliding hernia...that when this moves could cause issues like u described.....

Have u had the endoscopy? U have so much info I can not sort thru it all at the moment....

But if u have a sliding hernia, it may be restricting ur vagus nerve making it seem like a heart issue...since it is a sliding hernia they can be harder to detect.

Ask about this possibility.
Good Luck

[jdub2903]

No I'm scheduled to have the Endoscopy Tuesday next week.

[selmaS]

  Good luck with it and do let us know what the results are.

[jdub2903]

I completed my Endoscopy this morning and was asked to return tomorrow for a Ultrasound of the Abdomen. The interrior of the Esophagus was very red and irritated and I was stated to have Gastrtis. The Ultrasound should help determine how exstensive the damage is and what the route cause of the Reflux might be. Does anyone no potetial causes of Gastritis and do they cause the pains and complications I noted to be experiencing in my earlier post such as working out or lifting heavy weights and chest tightness?

[kevieb]

I am assuming they took biopsies when they did your endoscopy.  the extent of damage can only be seen on a cellular level---I haven't a clue how an ultrasound of your abdomen could tell the extent of tissue damage from reflux to your esophagus and to your stomach from gastritis.

I have had severe reflux for almost 22 years.  I know the pain you are talking about in your chest and your back--I would get that instead of heartburn.

Reflux can irritate the esophagus,which I believe can irritate the trachea in turn, which could account for the shortness in breath.  i occasionally get a tightness in my chest and feel like I am a little short of breath.

I have to burp quite often when I lie down in bed--especially if i just took a drink of water---reflux can cause burping and sometimes hiccups.

Your working out could definitely cause your symptoms to worsen--I would think especially the weight lifting.

One thing to remember, the PPis can stop the burning, but they cannot stop the reflux.  I cannot even bend over enough to make my bed without stuff coming up if I have eaten anything recently.

I had a surgeon try and tell me I needed to have surgery for my reflux about 16 years ago--sure wish I had done it.  i have developed another esophageal condition which is probably secondary from having reflux for so long.

I am now having to drink some sort of steroid to get my esophagus into the best shape possible so I can have the surgery to fix the reflux.  I have a hiatal hernia.    

I have a child that was born with a hiatal hernia.  even on prevacid and carafate, her esophagus was getting ulcerated at 8 months old--she had a fundoplication at almost 10 months old--and they discovered a good sized hiatal hernia that had not shown up during two upper GIs and an endoscopy.

[jdub2903]

Yes a biopsy was completed and I'll have the results Thursday. The Ultrasound request was prompted from something she saw during the Endoscopy either to rule out something or obtain a more indepth look. On weekends in the morning I can perform my normal workouts with no issues on a empty stomach but after having breakfast or lunch and working out in evenings I dont get the same results and feel as if extra air or food is restricting the airways even hours after the meal. How was the hiatal hernia finally detected? How does that restrict breathing because someone mentioned I might have a sliding one but I'll guess the doctor knows once the lab results come in. I've been taking Omeprazole and Rinitidin for over a month now and although I can say I notice a difference it hasn't completly gone away what other medical options outside of surgery might be considered to resolve this and how long does it take to notice a difference once on meds? My main concern is not being able to workout without the flaring up after a meal any suggestions?

[selmaS]

  Good luck Thursday....let us know what u find out. ((hugs))

[kevieb]

are you asking how my daughter's hiatal hernia was detected or how mine was detected?  My daughter's did not show up during two upper GIs and an endoscopy--her reflux was just so severe that she was failure to thrive, anemic, and refluxing almost 25% of the time--besides the damage to her esophagus.  she kept very little down and was not gaining weight.  She also had prolonged episodes of reflux---the longest was 44 minutes--and she slept right through it while it burned her esophagus.  she actually reluxed more in an upright position than she did in a lying down position.  They discovered her hiatal hernia when they went in to do her fundoplication.

I had suspected for years that I had a hiatal hernia after my pregnancy with my twins.   I have had to have my esophagus dilated 4 times.  i asked for a copy of my records, and looking at one of the past enoscopy surgery reports, I saw that the surgeon said I had a small hiatal hernia----but he had never told me.

I think the restricted breathing, or chest tightness, can be caused by the reflux irritating the esophagus and causing spasms, which can irritate the trachea----I think that is what I was told---but not positive--it's been awhile.

are they making sure you are taking your ranatidine and omeprazole separately----I think they might interfere with each other if taken too close together.

personally, I prefer prevacid (lansoprazole) over omeprazole (prilosec).  I found zantac to be worthless--but it may be helpful as an add on to the PPi you are taking.

You aren't having any problems with your morning workout because you don't have anything in your stomach to reflux back up.

The only thing I could suggest about your evening workout would be to maybe try waiting at least 3 hours after you eat before you work out--but it sounds like you have tried waiting hours after eating already.

It usually will take about 3-4 weeks for damage to heal from esophagitis once you are on a medication---which should alleviate any burning and pain--but it won't stop the reflux from coming up---you will still be able to feel stuff coming up--it just won't burn or hurt.

I am not aware of any other medical options, except for a motility drug if you happen to have a motility problem---but I think you would have probably had symptoms long before now if you had a motility problem.

Is the asthma something new since Nov 2012?  I am wondering if you might be having aspiration problems during your sleep from your reflux.

My personal feeling, is that if the medication is not giving you the relief you want from the reflux and it is keeping you from being able to work out and if it is causing you breathing problems------that you are probably a good candidate for reflux surgery.

Just my opinion--but that's what I'm planning to do myself.

[jdub2903]

Well here we are back to square one again after meeting with the Dr and getting my biopsy results I'm here to say they've found absolutely nothing all test were normal and she is as puzzled as I am. The doctor believes it might be some kind of reactive airway issue to allergies which I had an exstensive test done and was ruled only allergic to dust mites. I'm no doctor but perhaps someone can recommend another cause because Gstritis can't just be present without a trigger and as stated before the symptoms flare when working out after having any kind of a meal. See my results below and if anyone can think of a cause please let me know your thoughts.
Gastritis: No Infection
Duodenum: Normal
Ultrasound of the Abdomen: Normal
Tissue Samples:
Duodenum Biopsy - BX-Duodenal (Intact Villous Architechture with no increased intraepithelial lymphocytes)
Gastric Biopsy - BX-Gastric Antrum (Mild Chronic Inactive Gastritis, No evidence of intestinal metaplasia, No Helicobacter pylori seen on Diff Quik Stain)

[kevieb]

looks like the medication has done it's job since there is no damage and the gastritis is inactive--but they can tell you had it.

My guess is that just the reflux coming up could still be irritating things--it is an uncomfortable sensation, even if it is not burning or causing pain.

i have tested allergic to dust mites--but i get a totally different reaction--my eyes start to itch really bad and the whites of my eyes fill up with fluid and get red--looks like I have blisters on my eyeballs----but I get very irritated by smoke and such, which I have read, that it can often be that the smoke (or some other irritant) is causing the dust mite allergy to flare up.

The reactive airway isssue from dust mites doesn't seem to fit since you can work out in the morning without it bothering you.

[jdub2903]

Let me ask do you think getting a heart stress test is a good idea? Can heart issues complicate or start acid reflux issues?

[kevieb]

I don't suppose a heart stress test would hurt anything.

As far as i know heart issues have nothing to do with reflux.

[jdub2903]

I've scheduled for the stress test to be done this Wednesday. I've also spoke with a clinical nutritionist and she stated my diet might be a bit to healthy and I'm lacking enough starch and mainly fiber. I've started taking Fiber vitamins over the weekend and feel like it's helping but the true testament will be the ability to workout without having gas or reflux issues. If this works to resolve all of my problems afte rll the money I've spent this is a simple fix and a blessing so I'll keep my fingers crissed. Do you think it's possible for the lack of fiber to have caused all these issues?

[kevieb]

well, not enough fiber can slow your digestive tract down, and constipation can cause reflux.   Don't know if it could be the cause of everything, but it could definitely be a factor in the reflux.