Stomach Bloat and Breathing Distress

Please could you answer the Qs below:-

A) Myself: Age 42, 195 Ibs, 6'tall, male...

B) Daily intermittent Symptoms:

1) Muscle tightness in thoracic wall, esp.dorsal and along rear edge of diaphragm. Also, tension in larynx/neck.

2) Tightness in Lungs, lungs sensitive/'tickly',  awareness of mucous/ cough...at times leads to breathing distress/mild panic (worse part of the condition)!

3) NB: Symptoms always much worse after evening meal and at times of stomach 'bloat'/distension (Upper gastric IBS ?)- cannot inhale fully/ 'catch top of breath'.

4) Had a period of asthma-like breathing 'attacks' two years ago...

C) Other considerations:

1) Have suffered from ANXIETY - physical & emotional symptoms.

2) Have good peak flow/ lung X-Ray OK.

3) Physically fit/ active.

4) I seem now to have my acid reflux well under control.

5) The breathing problem comes and goes daily...usually associated with post meal times. At other times it can be totally absent. Some days are worse than others. Lack of sleep makes it worse. Keeping extremely busy and active improves the symptoms !

QUESTIONS

1) Could this condition be attributable to ANXIETY - do you feel that my stomach 'bloating' and resultant breathing distress ('self-interpreted model'!) sounds entirely plausible? I feel it probably is...but would love your professional opinion ?

2) If ANXIETY related, what is my best course of action to relieve the symptoms?

3) I am seeing a pulmonologist - can you suggest what course of investigation I should expect?

[National Jewish]

When you have a full stomach after your evening meal or a bloated stomach, this moves the diaphragm up into the chest area crowding the lungs.  This can certainly cause breathing distress.  Eating less at your evening meal, so that your stomach is not so full may help.  Also avoid those things that cause your stomach to bloat.
Diaphragmatic breathing can help you move more air in and out of your lungs.  This is the most efficient way to breathe and may improve your symptoms.  Learning this technique will help you to breathe slowly, regularly, gently, and smoothly all of the time.  Here are the instructions:
 Breathe in slowly and deeply through your nose.
 While you breathe in, count 1, 2 and push your stomach out.
 Place your hand on your stomach so you can feel your stomach going out.  This promotes the use of your diaphragm and your lower respiratory muscles.
 Breathe out slowly and deeply through your mouth.  Imagine that you are breathing out through a straw by

[Odins Gramma]

Do you do PLB to get some of the bad air out. Have you heard of the vent procedure where they go down the brochial tube and put a valvein where you are trapping air and the valve lets out the bad air. This procedure willhelpus alot. its new and just coming out. I read about it on The Boston Channel.com look under HealthBeat Emphysema patients.  I called hospital in my area and they do do the procedure here in co at prest St lukes. also talked to a gal from National Jewish and she is checking to see if they do it too. hope this helps. also would like to introduce you to a bunch of others of us on emphysema.net   they are also listed under the word EFFORTS when you do a search.

[NelsonAAA]

Yes...thank you for your suggestions, but I rather think the procedure may be rather too severe and not entirely appropriate for my muscle tension and mild breathing condition...and as far as I am aware, I do not have emphysema. Regards, Andy.

[Jane1]

Hi Andy

I can't give you a professional opinion - as I'm not qualified -
But your earlier Asthma may not be totally under control yet - The periods of Anxiety attacks will also hamper your breath control - being unable to catch a full breath or inhale deeply are symptomatic of Asthma and Hyperventolation Disorder - I have suffered from both and in fact one can make the other worse - The bloated stomach is something I can also sympathise with - Eating small meals is much more acceptable while you are going through this, as a heavy meal can make the problem worse - even orange juice can give you that full up feeling -  I would suggest you get a Pulmonary Function Test - which is a series of breathing tests carried out by a Respiratory nurse - this will determine if you are still suffering from Asthma - You  could also try breathing into a brown paper bag when you feel that your breathing isn't catching - try it for ten breaths ten stop and see if you can breath easier - Obviously the reflux won't help either - but the main thing ( and it is easier said than done) is try to relax - panic can bring on a feeling of breathlessness - very rapidly - when you feel breathless - talk to some one close to you - let them sit with you - if you can carry out a conversation between the breaths and be reassured by time - you will start to breath normally again - I know this isn't always possible - most of my panic attacks happened while I am on my own - you just must keep reminding yourself that you are okay and if you fall down ( worst case scenario) someone will pick you up.  Your peak flow is good but you should still book in for a PFT ( which is like a bigger version of the peak flow meter) Also it would be a good idea to take up some form of meditation and yoga - breathing exercises are incredibly helpful - we have to learn how to walk - why shouldn't we learn how to breathe - some say from our very first large intake of breath when we are born we set a pattern of breathing incorrectly , I believe for asthmatics this is only too true -

Talk to you respiratory Doctor - get the answers to your questions -

J

[NelsonAAA]

Hi Jane,

Thank you for your kind answer.

I shall be having a spirometry test. I had one a few years ago and it was fine (but, before my asthma-like 'attacks'.

I do not think I have conventional asthma.

My breathing problem only really starts when I have stomach 'bloat' due to anxiety induced Upper Gastric IBS. This seems to be due to ballooning effect and pressure on my diaphragm.

However, I certainly have not discounted a type of asthma, maybe stress related and await professional comment...

THANKS,

Andy

[Concerned lady]

Dear Andy,

Might you have any food sensitivities that could be worsening your GERD (gastro esophageal reflux disease), leading to VCD (Vocal Cord Dysfunction), also known as laryngospasms?

Sometimes, food sensitivities (intolerances), which are not food allergies, can cause bloating, leading to some reflux episodes. If it's a high up kind of reflux, called LPR (laryngo pharyngeal reflux), this can cause breathing problems, when stomach liquid burns the vocal cords &/or lungs. (Laryngo means larynx/voice box, behind the adam's apple in the neck. Pharyngeal means throat area, just above the larynx.)

Some examples of food sensitivities include lactose (milk sugar) intolerance, casein (a milk protein) intolerance, gluten intolerance (gluten is found in wheat, rye, oats, barley, buckwheat, etc.), etc.

Sincerely, Concerned lady
<a href=http://cantbreathesuspectvcd.com>http://cantbreathesuspectvcd.com</a>

[NelsonAAA]

Hello,

Thank you for your kind COMMENT...very interesting indeed.

For many years I had relatively serious acid reflux. A combination of muscle tension in my larynx (stress/anxiety) and acid reflux even gave me ulceration around the vocal cords - most unpleasant.

I have for many years suspected acid was getting on my lungs.

However, I now feel that with my recent major weight loss, small regular meals, PPIs and fat free diet I have almost totally reduced my acid reflux. I no longer have any symptoms of GERD or oesophageal discomfort, as before.

But I still get the tight chest and bloating...

I've come to believe the bloating is a form of IBS (I've recently cut out dairy products and the bloating is much improved !). The breathing problem, which may be a form of asthma induced by anxiety(?), is seriously aggravated by this stomach bloating...due to upward pressure on my diaphragm.

But, even though I do not seem to have GERD anymore...I cannot entirely discount acid being the culprit for the breathing problem...it always niggles and gnaws away at me. My Gastroenterologist said it was unlikely unless I was sufferings serious GERD, which I'm not. But I still can't help thinking that I'm inhaling acidic vapours, of my stomach or whatever !

Regards,

Andy

[Concerned lady]

Hi Andy,

Your "gut instinct" may be valuable to act on, by seeing a doctor who is knowledgable about how a high up type of "silent" reflux can burn vocal cords &/or lungs, etc.!

One kind of high up reflux, called LPR (laryngo pharyngeal reflux) often doesn't cause any heartburn symptoms. Yet, this high up LPR, can cause throat problems, breathing problems (by burning the vocal cords &/or lungs, etc.).

And, there are non-acid types of GERD (gastro esophageal reflux disease) that can still send corrosive (alkaline or neutral) liquid up the esophagus, reaching vocal cords &/or lungs, etc.

If you can be seen at Nat'l Jewish, in Denver, Colorado, they could diagnose you. If not, their LUNG LINE medical people may be able to recommend a doctor in your area, who has studied and learned, at Nat'l Jewish. Call the LUNG LINE, at 1-800-222-LUNG(5864).

Sometimes the term IBS (Irritable Bowel Syndrome) is used, when the underlying causes have not yet been discovered. The fact that you improved by getting off milk & milk products, implies that you may have a sensitivity (intolerance) to something(s) in cow's milk, such as lactose (milk sugar) &/or milk proteins (casein, whey, etc.), etc.

Some good Allergists can help to discover that and other possible food intolerances. Recently, a gluten intolerance, for example, is becoming more well known by doctors and the public, than formerly. Gluten is found in wheat, rye, barley. Oats & buckwheat have gluten-like substances in them, or, can be contaminated with gluten, at the processing plant. Rice (brown rice) has no gluten.

People who have gluten intolerance, yet continue to eat gluten containing foods & beverages, sometimes get intestinal &/or stomach disturbances (digestion, absorption, etc.), leading to reflux, leading to problems with esophagus, throat, breathing (vocal cords, lungs, etc.).

Keeping a food/beverage diary (include environmental factors etc.), can sometimes help, (share results with the Allergist, Gastroenterologist, etc.) to show what foods seem to agree or don't agree with a person. Avoiding such foods, might lessen the rerlux, and this may help to cause less "IBS".

Sincerely, Concerned lady
<a href=http://cantbreathesuspectvcd.com>http://cantbreathesuspectvcd.com</a>

[NelsonAAA]

Yes...the more I think about it and the more I believe that I am suffering the effects of my stomach contents migrating upwards and effecting my larynx/lungs. I've always believed it, but have been put off by Gastroenterologists, who claim that you need a tidal wave of acid reflux to do any damage !

[NelsonAAA]

Furthermore (yes...there's more !!!)

I have a history of relatively serious GERD with terrible heartburn and larngeal ulceration. I had a period of laryngospasms (breathing attacks) a couple of years ago.

I suspected GERD at the time.

I have lost alot of weight and have improved my diet...And I take PPIs for the acid. The acid reflux seems much improved.

However, I can't help thinking that I still have some evidence of upper oesophageal reflux eg cough, mucous, sour burps, laryngeal tightness, etc...

Although, of course these could all be caused by anxiety - a tight chest and IBS. But I prefer the acid culprit model !

[Concerned lady]

Hi Nelson,

I saw your new message posted above. See what Nat'l Jewish medical people recommend, for treating Laryngo Pharyngeal Reflux (LPR).

Also, when you can, take a look at some reflux tips (ideas), in my website. Get your doctor's approval, before trying the tips.

Because you used the word "whilst", I'm wondering if you are from the U.K.  People whose ancestors are from England, Ireland, Scotland, Wales, Italy, Scandinavian countries, northern Europe, & northern Africa, are at higher than average risk of having an inherited tendency to have a gluten intolerance. You could try avoiding gluten for a month, to see if this lessens your possible LPR type of reflux.

Gluten is found in wheat, rye, barley, oats, buckwheat. Brown rice is gluten-free.

Concerned lady
http://cantbreathesuspectvcd.com

[Sutera]

Hi Andy, I too have exactly the same symptons as you described and I suffer from anxiety and panic attacks. I have noticed recently a lot of bloating in my stomach and I feel sometimes as though I cant breathe properly. Although I have had the breathing thing on its own for a few years now. But it has gotten worse lately due to the bloating so Im not sure if I have two things to worry about here (IBS) or whether its all in the mind! It feels as though I have a very tight belt around the area just under my chest and it feels as though its being pulled tighter and this leads to the sensation of not being able to breathe properly.This is turn leads to greater anxiety! Its like a vicious circle, typical of anxiety/stress.Ive had blood tests done and an ECG as I have cardiophobia and all is ok there. I was also experiencing a stitch type pain under both left and right ribs, but this seems to have subsided lately.Im sure a lot of what you are experiencing is anxiety, the symptons of this condition are so real, Ive had lumps in the throat,palpitations,you name it, Ive had it, always convinced I was going to die but Im still here!I really hope you are feeling better now anyway, I always feel so if I know im not the only one and stress/anxiety are mentioned as likely causes.Take care :)

[NelsonAAA]

Hi Sutera,

Yes...you are most certainly correct. Most of this is caused by anxiety. But anxiety does produce some nasty physical problems as well, that cause real physiological distress eg acid reflux on the lungs, etc...

The secret is controlling the stress/anxiety and that in itself can be a daunting challenge, although it can be achieved. I find time seems to be the big healer.

Regards,

Nelson

[michaela1967]

Dear all
I have been back and for doctors for 7 years ,because i get very bloated mainly after eating and i find it difficult to breathe because of this .
I am 37 ,I was diagnosed with asthma when i was 21.
I have just changed my drs as my previous dr was rubbish,and he said it was all in my mind .I have been diagnosed with hiatus hernia about 6 years ago and now they tell me i have a thing called costochondritis ,(inflammation of the ribs ).
My breathing is getting worse ,I have kept off wheat ,dairy and cant eat things like tomato,onion,cream sauces ,so my diet is a nightmare .I have lost a stone cutting out wheat but feel very depressed as nothing seems to be working .My new doctor has just told me i also have ibs ,things seem to be going from bad to worse whatever i do .
Has anyone any ideas i know its a longshot but i would be grateful for any information.
many thanks
michaela

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