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Rhinoplasty surgery done. Experiencing shortness of breath, swallowing difficulty. GERD related?

Dec 2012
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General & Family Physician
Practicing since : 2012
Answered : 1694 Questions
The symptoms below started after a rhinoplasty surgery done to remove excess tissue and improve the nasal passage. I subsequently had a second rhinoplasty surgery as one nostril was consistency blocked. The second surgery worsened the symptoms below therefore I am assuming a relationship.

1.     Shortness of breath – I have constant shortness of breath with pressure on my chest all day, every day. Sometimes I am not able to breath in air for a few seconds
a.     My shortness of breath symptom is exacerbated by
i.     Talking
ii.     Walking
iii.     Eating
iv.     Drinking
v.     Heat
vi.     Stress
2.     Difficulty in swallowing water & food
3.     Accelerated heart rate – My heart beats faster than normal when I walk.
Note that I am not overweight or unfit. I don’t drink alcohol, smoke or take drugs.
4.     Yawning – I am yawning more than usual. There is a warm perhaps acid like taste to my yawns.
5.     Sneezing and hay fever symptoms – These symptoms were consistent with Perennial Rhinitis. I was prescribed beclometasone dipropionate nasal steroid spray which solved the problem. My nose is not blocked anymore.
6.     Wheezing – I have light wheezing only at night. This is fixed by using salbutamol sulphate at night.
7.     Mild antral gastritis – I have been taking omeprazole and gaviscon which fixed my heartburn issue but not my breathing issue.
I had an endoscopy to see if I have GERD but there was no evidence of oesophagus damage or relaxed sphincter. The doctor found antral gastritis instead. My GP told me that I may still have GERD but it could be an early case which is why I there wouldn’t be any sophagus damage.
8.     Stich – I get a stich very easily     

I don't know what is causing this issue. Though I don't have any wheezing during the day, could it still be asma related? Can some steroid help me?
Or could it be GERD related even if the endoscopy disproves this theory? What would i do to fix my breathing issue if I had GERD?

I really want to breath effortlessly like I used to. Please let me know what you think
Posted Sun, 12 May 2013 in GERD
Answered by Dr. Nsah Bernard 8 hours later

Thanks for posting on XXXXXXX

I am pleased to be able to help you answer your health query,

It is hard to correlate why after a surgery that was suppose to improve your breathing you suffer more from shortness of breath (order wise known as exertion dyspea) except of course you were already having an underlying diseases condition that probably has been exacerbated by anesthesia.
From your description your problem of shortness of breath maybe coming from two main organs either your respiratory organ or your cardiovascular system or both (it will be hardly going to be digestive as shortness of breath due to GERD is reactionary due to the pain provoked at the level of your epigastrium).
It is understood that you are young, with no cardiovascular risk factors as you mentioned meaning we would curve more towards a respiratory problem (non the less consultation with an internist will be recommended).
Amongst the different possible respiratory problems we have (starting from the most problem)
- Asthma= Given your history of sinusitis/rhinitis which required surgical correction, plus the fact that you were relieved by salbutamol after wheezing episodes, this will be the most likely cause for concern. Your doctor will have to look further into this and provide you with appropriate treatment. Your treatment could be B2 mimetics or steroids or both. Example of medications that could give you some relief are seritide, ventoline spray/tablets, betamethasone spray/tablets etc
- Chronic obstructive pulmonary diseases (COPD)= rare for your age but could be responsible for your symptoms. This could be as a result of emphysema given a post-surgical complication
- Bronchiectasis: here you will require specialist consultation with a pulmonologist.
- Other obstructive respiratory diseases will need to be excluded if above suspicions do not tie.
Other possible causes order than respiratory (cardiovascular diseases) are:
- Acute coronary syndrome: In which case combining all of your symptoms i.e dyspnea, retrosternal chest discomfort (which mic mic GERD) etc this could be the most likely. An electrocardiogram and cardiac enzymes are important both for diagnosis and directing treatment.
- Heart failure: difficult to think about but possible if you had a congenital heart diseases that just decompensated.
As you can see, your actual treatment will depend on the actual cause of your shortness of breath. Generally steroids can help, but if you are suffering from a heart diseases then they will be useless.

Hope this helps and I have answered your question. Please if you are satisfied do accept my answer.

Dr. Nsah
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