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Have difficulty in swallowing, gulping, coughs and sneezes. GERD test came negative. Asthma?

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Allergist and Immunologist
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Hi my son has had numerous tests for gerd but all came back good but still has symptoms. He has difficult swallowing, gulping constantly, coughs all the time especially after eating, and sneezes a lot after eating too. But he does both all throughout the day. He has shortness of breathe while doing any activity. His nostrils will flare and you can hear him like pant.. Could he have asthma or allergies?
Posted Mon, 1 Apr 2013 in Asthma and Allergy
Answered by Dr. Sujoy Khan 9 hours later
Welcome to Healthcare Magic and thank you for writing to us.

By dairy protein allergy, I think you mean cow's milk protein allergy and this was proven on specific IgE blood tests.

First thing, difficult swallowing, gulping constantly could mean there is an upper gut problem (hiatus or a pyloric obstruction) and I hope these have been excluded 'with the numerous tests for GERD'. If that is so, reflux disease is quite common at this stage and Nexpro junior sachets should help with lowering the acid reflux.

Shortness of breath, sneezing are signs of allergic rhinitis/asthma and you ought to ensure that IgE tests against common inhalant allergens and foods are excluded. A test (screening test) now available is the Phadiatop panel that checks for allergies (specific IgE) against common foods and inhalant allergens and is recommended.
This will also check for cow's milk protein allergy.

Montek-LC KID tablet will help with some of activity-induced shortness of breath that is recommended once a day at night.
Nasonex nasal spray one spray per nostril once daily will help with the rhinitis.

I hope this answers your query and will be happy to help with further queries.
Best Wishes.
Above answer was peer-reviewed by
Follow-up: Have difficulty in swallowing, gulping, coughs and sneezes. GERD test came negative. Asthma? 3 hours later
What if the gulping and constant swallowing and swallowing hard started after the gastrocopy and colonoscopy was done? Would that make a difference in the test results. Cause it started like a week after that test was done. And the milk protein allergy was discovered only cause he had blood in his stools at 6 weeks old. We haven't had any further test to check it.
Answered by Dr. Sujoy Khan 6 hours later

Procedures such as gastroscopy and colonoscopy normally does not affect allergy results or of blood tests in general. A week later makes it more unlikely that the procedures had any effect on this as well.

Babies as early as 6 weeks should not have been on cow's milk protein and therefore intolerance is not unusual. It is important that this is reviewed (i.e., cow's milk protein allergy) at this point in time to better understand the sensitivities or allergies that your child may be suffering from.

Best Wishes.
Above answer was peer-reviewed by
Follow-up: Have difficulty in swallowing, gulping, coughs and sneezes. GERD test came negative. Asthma? 4 hours later
The allergy was from him being on similac . The dr said it has the milk protein in it. He is in alimentum now and has been on this formula since. We haven't seen any more blood in stools.since. So hopefully we get some answers soon from his GI dr. We're waiting to see if he needs to see a dr for his shortness of breathe and see an allergist? So I should recommend seeing an allergist? He has a cold today and his reflux is acting up. I can see why the test all came back good. Cause when we were in the hospital to stay they wouldn't let him eat any snacks . He only drank his formula and wasn't allowed to move around. So when he's not that active his reflux isn't that bad. Ad he couldn't get active enough for them to hear his shortness of breathe. Tanks a lot for your time ..I appreciate it. XXXXXXX
Answered by Dr. Sujoy Khan 9 hours later

The only other possibility is a milk protein induced enterocolitis like syndrome (FPIES), that can happen with other foods such as wheat, nut proteins.
There will be abdominal cramps or pain followed by blood in stools within 1-2 hours of eating the offending food.

1. Treat of the reflux is important.
2. Please get him to see an Allergy specialist and explore the options as discussed previously.
3. Occasional salbutamol inhalers or montek-LC KID could be tried to see there is symptomatic relief.

Best Wishes.
Above answer was peer-reviewed by
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