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Can a Hiatal Hernia cause asthma like symptoms?
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Can a Hiatal Hernia cause asthma like symptoms?

Whilst on holiday in July, towards the end i received what I though was an asthma attack. I suffer from hayfever and only once before felt out of breath through it.To cut a long story short, the asthma medication did not seem to work, the only thing that releived the chest tightness was Amoxicillan. Later it came back again and after a stint in hostpital they asked if i had heartburn. I said yes, now and again. They said I could have reflux and gave me 30mg of Lansoprazole and told me to come back for an endoscopy. Whilst waiting for this, three weeks, I still had breathing problems, it does not matter how much asthma medication I have i am still breathless, i cannot go out and i have been off work. I had the endoscopy two days ago and the doctor says I have a hietus/Hiatal Hernia that is inflammed and infected. He has taken some samples and i have to come back and see him in a week. I am still breathless and seem to have constant heartburn. I am 33 years old, i do not smoke and before all this i had a great life. The past couple of months have been a nightmare. I have not been out and i cannot spend much time with the kids and wife without feeling ill. My chest x-ray was fine and all the heart test are fine. I cannot understand why the doctor has not given me anything to get me throught this week! Can a Hiatal Hernia cause you to feel really out of breath?Is it normal to take samples?Will I get better, because i cannot see any light at the end of the tunnel!I go to the gym (used to!) could this have caused the hernia?
Has anyone else had this?
Regards Karl





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If you are continuing to feel out of breath and this is not helped by the asthma medication, this could be due to some problem other than a hiatal hernia or heartburn.  A lung specialist or a heart specialist would be able to determine if you have some other problem causing this.

A hiatal hernia can crowd the chest area giving the lungs less room to work.  Eating smaller meals can help since a full stomach also crowds the lungs causing increased shortness of breath.  Often this is worse with any movement that would cause you to bend forward at the waist since it further crowds your lungs into a smaller space.

It would be normal to take samples since it looked inflamed and infected during the endoscopy.  Then further tests can be done to find out what could be causing the inflammation and infection.  Only then will your doctor be able to get you started on the best treatment.

Gastroesophageal reflux disease (GERD) is the back flow of stomach contents, including digestive juices, into the esophagus or food tube.  This is most commonly called acid reflux or heartburn.  Your shortness of breath could be caused by esophageal spasm from heartburn.  Reflux can come all the way up into the mouth and nose.  When this happens the material can be aspirated, dribbling into the windpipe and lungs.  This could also explain your shortness of breath.  Please check with your doctor about these possibilities.

Reflux can cause the following symptoms:
14 Comments
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Avatar_n_tn
Reflux can get into your lungs causing the breathing problems.

See this link on Hiatal Hernia: http://www.emedicine.com/aaem/topic251.htm
Excerpts:
"*Hiatal hernia also causes symptoms of discomfort when it is associated with a condition called gastroesophageal reflux disease, commonly called GERD. This condition is characterized by upwelling of stomach acids and digestive enzymes into the esophagus through a weakened sphincter that is supposed to act as a one-way valve between the esophagus and stomach. Hiatal hernia is thought to contribute to the weakening of this sphincter muscle.
......................
Lifestyle changes are often necessary to avoid symptoms.

Modify your activities:

-Minimize heavy lifting, straining, bending over.
-Improve seated posture; don
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Avatar_n_tn
If the PPI you are taking, lansoprazole, doesn't control the reflux, surgery might have to be considered. See:
http://www.emedicine.com/med/topic1012.htm  Hiatal Hernia
Excerpt:

"Surgery is necessary only in the minority of patients with complications of GERD despite aggressive treatment with proton pump inhibitors (PPIs). Because only a minority of patients with hiatal hernia have any problems, this represents a very small proportion of patients with sliding hiatal hernia; most patients with problems are managed medically.

By far, the majority of patients who would have undergone surgery in the past are managed successfully today with PPIs. However, young patients with severe or recurrent complications of GERD, such as strictures, ulcers, and bleeding, who cannot afford lifelong PPI treatment or would prefer to avoid taking medications long term, may be surgical candidates.

Another group of patients who are surgical candidates are those with pulmonary complications, in particular, asthma, recurrent aspiration pneumonia, chronic cough, or hoarseness linked to reflux disease."

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Avatar_n_tn
Thank you Ellis. I am going through a bad time at the moment. I think I am also thinking about my breathing too much, which is changing my pattern of breathing. I have just been told as what you have just said, from my doctor. However he seems to think I have other problems as well. That is why he reffered me to the chest specialist. The chest specialist thinks i am over breathing and I have an appointment with someone who will teach me to breath correctly. My own thoughts are that because of the hernia, and all the drinking and rich food i had on holiday triggered off an asthma attack. I have since been obsessed with my breathing which has made it worse, because I am getting anxious and bringing on the asthma again. The hernia is not helping either. That is my thoughts i may be completely wrong. I think i need to calm down and forget about it and let the doctors do their job. I will also do the things you have posted, thank you very much. I have however been eating good for the past month and have not touched a drink. Could the stress have been making my reflux/heartburn worse? I just need to calm down, but being in an ambulance not being able to breath would freak most people out!
I would be interested if anyone else has had my symptoms?

Thanks again Ellis, you have given me some peace of mind

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Avatar_n_tn
Hi Homer,

Just a note to say that I had similar symptoms.  I started out with a cough that would not go away and later developed difficulty breathing.  Everyone assumed it was lung problems but I have since found out that acid reflux might have caused my bronchitis.  I am now taking pantoloc for the acid but I still get tremendous pain in my ribs after I eat something.  Do you have symtoms (symptoms) like these? If so, it could also be a Hiatal Hernia.

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Avatar_n_tn
Hi Bigtone,

It is nice to hear for once that I am not the only person who feels out of breath through the reflux.Yes I do have a hiatal hernia and it is giving me terrible heartburn. The 30mg of Lansoprazole that I was given does not seem to be working. I wonder if another type would better suite me, could some medication work on some people and not on others? I may just need a larger dose. I will ask the doc the next time I see him. Did your breathing problems go away? Did you take asthma medication? I have read somewhere that the steroid in asthma medication relaxes something in your throat thus increasing the reflux! Which would make everything worse again I suppose.

Cheers

Homer
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Avatar_n_tn
Homerjsimpson,

The month of October was a nightmare for me.  Since 1998 I wake up at 4 am every morning with shortness of breath, but this would disappear in the winter months.  The months of August and September of this year I had this shortness of breath every night and my stomach would gurgle when I did catch my breath.  So I felt that my stomach was somehow involved.  I have been on Singular, Advair and Nexiun which did not change my breathing problem at all.  Even the rescue inhaler did not work.  In the month of October my stomach started to give me real problems.  I would take my nexiun every morning but had bad acid reflux by dinner so bad that I could not eat.  It also felt like I had a rope tied tight around my throat.  On October 8 I woke up not able to breath, to the point of going to the emergency room.  I was so consumed by trying to breath and I was afraid to eat, to take my meds and afraid to go to sleep because of these breathing episodes that I was having.  My breathing problems were now effecting me in my daylight hours and was controling my life.  My doctor ordered an Pulminary function test (still don't have results from that) and Echocardiogram with came back perfect.  I would go 30 hours without a meal and would have acid reflux, so then I knew there must be some sort of blockage in my stomach.  My doctor is a hard person to get an appointment with and have not been able to get back to see her, but I did seek out an Iridologist.  An iridologist falls on the Hollistic side of medicine.  She was the one that told me that I had a hiatal hernia and I also had a section of my intestine that was inflamed, so the combination of of this inflamation (inflammation) put pressure on my lungs.  She said that this was triggered by a highly stressful event. She gave me some digestive enzymes to take with every meal and I also take a dropper full of a liquid herb combination called Lily of the Valley & Blessed Thistle(worst stuff I have ever tasted)  I am off of all other meds right now and have only been eating about 1/2 of what I use to.  I have been taking this stuff for 2 1/2 weeks and I feel much better.  I have also stopped drinking cokes cold turkey and have not had a alcoholic beverage since September and I make sure I am done eating 3 hours before bed.  I never laydown after a meal anymore either.  As long as I do not overeat I can breath.  I have not been brave enough to eat beef yet, but hope to soon.  I do wake up in the middle of the night, usually I just catch my breath once and I fall right back to sleep, which never happened before (I was always up for the entire night)
I am now seeking a new doctor to have an x-ray of my stomach to find out how bad the H/H is.  I hope this has helped you.
tennisgoober2
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Cheers Tennisgoober

I have also had a nightmare few month's. My health is all over the place. The stomach doctor does not think the HH is bad enough to effect my breathing, the chest specialist seems to think that I have mild asthma with chronic hyperventilation. I am doing breathing exercises now, breathing through my nose. It has made me feel worse! I am messed up, one day I have heartburn, the next day I am short of breath, the next day I feel sick, the next day I feel like I have flu!!!!!!! on and on. I think about my breathing all the time (because it does not feel right. I think the stomach guy thinks its anxiety. I have never had this before, and was healthy and fine before I went on my holiday. I just want to get better. The specialist do not want to see me until January, which I suppose is good because they are not worried. But I am. I have a good peak flow now, but I have not done any lung tests apart from that. I am trying to relax but, nobody else seems bothered apart from me. I think everybody thinks its in my head. Oh to be normal again.
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Avatar_n_tn
Hey Hommer;

Sorry to here that you are still having problems.  I finally got my Pulmonary Function Test back after 5 weeks and it was normal.  I had an upper GI done last week and it confirms that I have a hital hernia.  My GI guy also thinks that it is to small to affect my breathing, but everything that I have read on the internet states differently.  The day before I had my upper GI I had no heartburn for the first time in 2 1/2 months.  My heartburn/reflux seems to be undercontrol and my breathing is better but is still not right.  I work with 2 other asthmatics who tell me when they overeat that they have breathing problems also.  My next option is to have allergy testing.  I have exhausted all of my medical beniffits for this year and will have to wait until January to be tested.  After that I am going to an acupunturist(sp?)
Good Luck
Tennisgoober
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Avatar_m_tn
Hello Homer,

For many years I thought I had acid reflux that was causing me breathing problems. I had all the tests and they proved negative, although I did have a slight hiatal hernia. I believed that I was suffering from the effects of aspiration of stomach acid. However, my problems have now been explained as anxiety and hyperventilation syndrome (overbreathing). This now seems very plausible. I suffer a range of physical and emotional anxiety problems, including flu-like symptoms, aches, fatigue, headaches and of course, acid reflux and breathing distress. At times of minimum stress, these symptoms can all just dissappear... I would strongly advise you to seriously consider the ways in which your anxiety can cause you problems and think about controlling your overbreathing - this will reduce your anxiety symptoms and improve your breathing. Good diaphragmatic breathing through your nose can greatly improve your condition.
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Cheers LordNelson (like the name!)

I think you are right about it being anxiety. I too get flu like symptoms, short of breath etc. I have started to breath through my nose the past month and all though it was horrible at the start I do feel better now. I however now have aching feet and hands, dizziness and feel like I am getting flu then it all goes away! The hardest part is at night. I can hear my heart pounding and then when I feel like I am dropping off to sleep I wake up with a start thinking I am being suffocated! Then some nights I am fine. I get short of breath and heartburn somedays and there does not seem to be any of the same food that is causing it. Could anxiety make these symptoms seem so real? I had a cough for a few weeks as well but that has gone now. I think I am paying too much time thinking about my health which is causing all this. Could this be possible? I do not feel stressed, can anxiety come for no reason? Weird or what! or am I thinking about being ill which is stressing me out and causing the anxiety, thus there is a vicious circle. If it is anxiety how do you sort it out. I mean I thought I was relaxed. I suppose deep down I know I am not.
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Avatar_n_tn
Hi Homer,

I came across this site trying to figure out why I am having these symptoms, and I wanted to comment on how I am feeling the very same symptoms as you are. I have had shortness of breath, was in the emergency room, all heart tests came back fine, they told me it was anxiety, gave me antidepressants and the shrotness of breath continued. It is hard to catch my breath at times, I feel like I have to yawn or breath heavy to compensate, and I feel ill, or get chest pains quite a bit. I was born with hiatal hernia, and was diagnosed with gastric ulcers 3 months ago. I am currently awaiting a visit to a specialist. You are definetly not alone. The pantaloc they have me on doesn't seem to do the job anymore, and I am now getting sour stomachs after every meal.
Good Luck to you on feeling better.
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Avatar_n_tn
I am 23 years old.  I went to my doctor about acid reflux, she gave me a prescription for Nexium, which takes care of the reflux quite well, but she referred me to a GI specialist to do an endoscopy.  I just got that done and I've diagnosed with a Hiatal Hernia.  I too have always had shortness of breath, and an urge to yawn to try to satisfy my need for breath.  Also when I would run I would get a pain in my chest (near the diaphragm) and everyone told me it was a side stitch and to run through it.  Well no matter how much I'd try to run through it I never could.  Also on occasion I will get a sharp pain in my chest which is emphasized when I breath in.  For the duration of the sharp pain (thankfully usually only a few minutes) I must take very shallow breaths.  I believe this all could be related to this Hiatal Hernia.  I have a follow up with my GI specialist soon and will talk to him about this.
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Avatar_n_tn
Howdy Homer!
Just wanted to say that your symptoms sound exactly like mine. Especially the part about constantly thinking about your breathing. It seems like sometimes I breath so shallow that I get light headed, my arm start to tingle and I feel like I'm going to pass out. I feel better if I stand up, but I can't stand up all of my life! I hope everything works out for you. I have decided that my thinking too much is a hassle, so I'm trying HARD not to think.

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