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Having shortness of breath, bloating of stomach and coughing. Two small nodules in lung. What could be the cause?

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General Surgeon
Practicing since : 1979
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FOR THE LAST FEW MONTHS I HAVE HAD SHORTNESS OF BREATH, BLOATING OF THE STOMACH AND COUGHINH. I HAVE HAD EVERY TEST, YOU NAME IT I'VE TAKEN IT. IT ALSO COMES WITH PAIN TO THE LEFT SIDE THAT GENERATES TO THE BACK. MY LAST TEST WAS GIVEN BY A GASTRLOGIST WITH A CAMERA GOING DOWN MY THROAT. SHE DAID EVERYTHING WAS FINE AND I DID NOT HAVE ACID REFLEX LIKE THEY THOUGHT I HAD. STOMACH WAS A LITTLE INFLAMED AND SAID IT WOULD GET BETTER BY TAKING MEDICATION. RECENTLY DID A LUNG TEST SAID EVERYTHING WAS FINE. FIVE YEARS AGO WHEN THE DOCTOR DID A COLONOSCOPY AND ANOTHER TEST THEY SAID I HAD 2 VERY SMALL NODULES ON MY LUNG. IN MARCH I WAS GIVEN A CT-SCAN AND WHEN THE DOCTORS VIWED IT THEY SAID THE NODULES WERE THE SAME SO THEY WERE NOT CONCERNED ABOUT THAT. THEY SAY NOTHING IS WRONG EVEN MY CARDIOLOGIST. SO WHY THE BLOATING, SHORTNESS OF BREATH AND COUGHING DRY COUGH
Posted Sat, 2 Nov 2013 in Digestion and Bowels
 
 
Answered by Dr. M Y Shareef 1 hour later
Brief Answer:
More information will be helpful .

Detailed Answer:
Hi XXXXXXX ! Good morning. I am Dr Shareef answering your query.

I would like to have a few more details about you :
1) Do you eat frequently from out side specially fried and fast food kind of thing ?
2) Do you consume any alcoholic beverages and do you smoke and if yes, what is the frequency ?
3) What kind of diet do you eat ? Does it include plenty of roughage and enough liquids ?
4) Did you notice any particular type of diet precipitates these symptoms of yours ?

In the meanwhile I would advise you to take a proton pump inhibitor, a prokinetic and a probiotic routinely for some time. Also please get a routine stool test done if not done so far. Go for a routine aerobic exercise programme like a brisk walk or a jogging depending on your medical fitness.

As all other investigations including all types of scan and endoscopic procedures are already done as stated by you, I won't advise any more specialised tests for you. I hope a blood sugar test and a LFT (liver function test) must have been done for you as a routine by your treating doctor.

Thanks for using XXXXXXX portal for your health problems. I will be able to help you more after receiving more information from you. Dr Shareef.
Above answer was peer-reviewed by
 
Follow-up: Having shortness of breath, bloating of stomach and coughing. Two small nodules in lung. What could be the cause? 15 hours later
YES DR. I DO EAT OUT ALL THE TIME, I DON'T DRINK AND STOPPED SMOKING ABOUT A YEAR AGO. THE BLOOD SUGAR TEST AND THE LFT TEST ARE THEY DONE BY TAKING A BLOOD TEST. IF SO THEY PROBABLY DID. I HAVEN'T TAKEN THE STOOL TEST YET! WHAT WOULD THAT REVEAL? I AM TAKING NEXIUM AND JUST STATED WITH PROBIOTICS. THEY ALSO DID A ENGIOGRAM, FOR THE HEART AND SAID EVERYTHING LOOKED OK.
 
 
Answered by Dr. M Y Shareef 4 hours later
Brief Answer:
Need to be investigated for gluten sensitivity

Detailed Answer:
Hi XXXXXXX ! Good morning. My regrets for the delay in responding to your answer as it was around 3.00 AM here in this part of the subcontinent when you posted your mail.

It is good that you don't drink and stopped smoking one year back which is a great achievement on your part towards you and your family/friends.

Also it is quiet re-assuring that your angiogram came out to be normal.

We do a routine stool test to see if there is any intestinal infection like bacterial/amebic infections which is common in this part of sub continent specially in those who eat out frequently. In this kind of infection, bloating of the abdomen and gastrointestinal disturbances could occur, and a course of appropriate antibiotic can relieve the patient of such problem.However possibly in your region amebiasis may not be very common.

Considering the symptom of shortness of breath associated with your gastro-intestinal symptoms, and your eating habits outside your home, if I were your physician, I would investigate you in line of gluetn sensitivity enteropathy, which is not very uncommon and is under diagnosed because of non suspicion.

Gluten is a protein component in the food specially fast food and others found particularly in diet containing wheat, rye, barley and a few others which when ingested may give rise to sensitivity reactions in the intestinal mucosa causing atrophy of the mucosa leading to such symptoms. I would suggest you to discuss on this with your treating physician so that they may investigate you in this line if already not done. There are some blood tests which detect circulating antibody/antigen in the body on ingestion of gluten. Also a biopsy of the intestinal mucosa during endoscopic evaluation of the intestines may confirm the diagnosis. I am not aware if a biopsy was performed in your case during the endoscopic examination.

The treatment of gluten enteropathy is not difficult. One has to change his dietary habits. Avoid eating out, and food supposed to contain gluten and also lactose and also avoid the food which you feel is precipitating your symptoms. Whether gluten sensitivity is detected or not, if you avoid eating from out, 75% of your problem will be solved in no time and you will get complete relief in due course. Also go for a high roughage diet with enough liquids. A discussion with a dietician in your area may give you more information on the diet you can have in such situation.

Please continue taking nexium, and the probiotic as advised by your doctor. As already advised by me earlier, you may consider some kind of aerobic exercise as a routine within your medical limits.

I hope this information will help you in discussing with your physician in this regard. Wishing you an early recovery. Dr Shareef.
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