burping, breathing difficulty on right side

[problemspatient]

Hi I've had really bad breathing problems for two weeks now but I think it all started when I choked on a piece of pizza a month ago. I choked on a piece of pizza at the end of may and swallowed it down because I started to panic and was alone. I didn't feel it go down properly. I felt ok until a couple of days after that when I could not breathe well. I was diagnosed with strep throat and given an inhaler. I felt better after the antibiotics, but I started burping up the whole month after that. Now these past two weeks have been horrible. I've been in and out of clinics because of breathing difficulty and pain on the right side of my chest. I feel like there is something there stopping my breathing from that side. I got an x-ray that said I have "nonspecific small fibrocalcific scars." So I got a ct scan and it says I have "focal minimal centrilobular emphysematous change of the anterior aspect of the part of the right middle and lower lobe as well as linguar division and left lower lobe, infra- and perihilar areas with small bullae." I haven't ever smoked and I'm in my twenties. Is it possible I aspirated the food into my bronchus and it's damaging my lungs?

[Paderla Anitha, DNB]

Hi, was a spirometry done? This can help rule out conditions like Asthma, which can cause nighttime symptoms of breathlessness. Also, lung function will help understand how well your lungs are functioning, and if the lesions seen in the CT scan are responsible for your breathlessness. Discuss this with your doctor.

In the meantime you can follow some lifestyle measures for the burping and see if they help. Take frequent small meals. Eat dinner about two hours before sleeping. Elevate the head end of the bed. Keep a food diary and note down what aggravates your symptoms and avoid them. Ensure to maintain optimum weight by regular exercise. Avoid non steroidal  anti inflammatory medications NSAID's, quit smoking, eliminate alcohol and reduce stress levels. These measures need to be practiced long term for results. Hope this helps!!

[problemspatient]

thank you for your response. It's just very difficult for me right now. I feel like I cannot breath and my throat feels tight at times and my front and back hurt when I try to breathe. At night it's difficult to sleep cause my heart feels like it racing and I feel congested in my chest area at least that's the best way I can describe it.

[Paderla Anitha, DNB]

Hi, like I said if the piece is lodged in the lungs, it should be picked by CT scan. Besides smoking, emphysematous changes in the lungs can also occur with pollution, coal and silica dust and manufacturing fumes. Rarely, emphysema is caused by an inherited deficiency of a protein that protects the elastic structures in the lungs. It is called Alpha-1 antitrypsin deficiency emphysema. Have lung function tests, this will help assess if the breathlessness is due to the lung findings. Frequent burping and breathlessness can also occur with conditions like GERD, (Gastro Esophageal Reflux Disease), where the acid contents of the stomach come up into the esophagus. Please discuss this with your doctor am sure he will provide further assistance. Warm regards.