Gerd induced asthma

[Allisonc78]

For the past several months, starting around Dec I started experiencing chest pains that weren't cardiac related. It was a sharp, dull aching pain around the chest no particular area. Then it started getting worse, it would spread to my arm, neck and even ear at times. I got checked out at a cardiologist and everything was fine there. I then started getting these asthma like attacks after I ate. This went on for a few weeks. I set up an appt with a gastroenterologist after that and had an endoscopy done. There were ulcers in my esophagus, but he didn't see any weakness in the LES. Eventually I started experiencing more constant shortness of breath and now have it constantly. I went to a pulm and got a pulm function test and it came back mild asthma. But he still seemed confused as to why it was such constant shortness of breath. I now think I have gerd induced asthma. I have never had it as a child. Do you think there are any surgical options to relieve the asthma symptoms? Even though he did not see the weakness in the LES could it still open at the wrong time?

[National Jewish Health]

What you describe does indeed suggest gastroesophageal reflux disease (GERD)-induced asthma and also, GERD as a possible cause of your chest pain.

You should ask the endoscopist/gastroenterologist what is the cause of the esophageal ulcers, if not GERD.  You might also ask how reliable is visual observation, in determining if there is or is not lower esophageal sphincter (LES) weakness.  Given the ulcers, you might want to ask about a pH probe to assess reflux.

The diagnosis of mild asthma, based on spirometry, does not explain your constant shortness of breath.  You should ask the pulmonologist, who apparently agreed with this conclusion, what other lung diseases or laryngeal dysfunction could cause your persistent shortness of breath, for example recurrent pulmonary emboli that are clots to the lung in which case the asthma, esophageal ulcer and suspicion of GERD could be "red herrings."  Pulmonary emboli can cause wheezing and the diagnosis should actively be ruled out.

As for surgical procedures to relieve asthma symptoms, you may have heard of bronchial thermoplasty as a semi-surgical treatment of asthma.  That is legitimate when all other therapeutic options have been exhausted, but other surgical therapies are absolutely not!  Do not agree to this or any other non-pharmacologic, surgical therapy.

The therapy for your asthma, confusing or not to your pulmonologist, should be optimally treated until your baseline pulmonary function is normal.

You may want to seek a second pulmonologist opinion.  You may need an exercise study.  Finally, heart disease could be contributing to your shortness of breath.  Your doctors should make sure that your heart is working normally.

[Allisonc78]

I also wanted to add I was experiencing these symptoms since I had my baby in July 07