Dr. Tinkelman I Would Greatly Appreciate Your Opinion!

[LowMac]

Dear Dr. Tinkelman,

(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 (Can come and go the same day!). I'm thinking it is relieved once I clear my throat repeatedly, as if it clears the irritated airway (I don't suffer any outward 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.)

[David Tinkelman, M.D.]

The most common reasons for repeated throat clearing are acid reflux and post-nasal drip, secondary to chronic inflammation of the nose and/or sinuses.  Acid reflux can be associated with chronic phlegm production and worsening of pre-existing asthma but it does not cause COPD and your symptoms are not very suggestive of chronic bronchitis, related or unrelated to reflux..

Good luck

[LowMac]

Thanks so very much! You have provided me some reassurance that I suspected to be true. My normal spirometry was my biggest stress relief but the ongoing mucous production has been literally life altering! I do indeed believe that my acid reflux disease is largely, if not totally responsible for this very undesirable symptom.

Thanks again!