HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Have A Hiatal Hernia And GERD. Getting Feeling Of Chest Tightness And Air Filled In Lung. Prognosis?

Posted on Fri, 17 May 2013

Question: I am suddenly having a hard time filling my lungs fully with air. When i do get a deep cleansing breath it almost hurts, like my chest is too tight to fill my lungs like that. I don't have any chest congestion, i'm a non smoker, i do have a hiatal hernia and pretty significant GERD. I started dexilant a few months ago because with nexium 40 mg BID i still had gastritis/esophagitis, esophageal ulcerations and irritation.

Answered by Dr. Satyadeo Choubey (23 hours later)

Hi,

Thanks for visiting XXXXXXX

A severe GERD can cause respiratory symptoms most commonly chronic dry irritating cough due to trickling down of secretions in respiratory tract. When I went through your medication I found you are currently on cetirizine ( Zyrtec) and fluticasone spray ( Flonase). These drugs are usually prescribed in patients of allergic rhinitis.

I wish you have told about the symptoms pertaining to allergic rhinitis like frequent, colds, running nose, sinus pain, sneezing, any allergy to dust, pollen etc . Why I am asking this because almost 50% patients with this symptoms have concomitant asthma which may manifest as chest tightness.

Here I will advise you to go for a simple breathing test called spirometry with reversibility testing. If it comes positive, your doctor may prescribe you some inhaled medication and you will be relieved of your this symptom in a matter of seconds.

Hopefully I have answered your query.If you have any further doubts, you can contact me.

Best wishes,

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Satyadeo Choubey (19 hours later)

I have a lot of sinusitis with post nasal congestion that builds up and becomes almost tissue~like in feeling that after a couple weeks drops into my chest rather than just a thin post nasal drip. This then becomes bloody and has a weird smell/taste. This is also accompanied by a sore throat and difficulty swallowing. It is chronically hard for me to drink very cold fluids over the last couple years as it burns my throat. I have frequent oral ulcerations also ranging from 1 to 5 at a time on the inside of my lower and upper lip, occasionally inside cheeks and more recently had one on the side of my posterior tongue and under my tongue almost on my gums. They get larger and larger for a week or so and then start to heal usually lasting a couple weeks before gone and these occur probably 6 to 8 times a year. I had a nasal culture done at the end of one of these cycles that came back positive for HFlu but not MRSA like I expected since I have been a nurse for 7 years and work in close contact with a lot of CF patients. I very seldom have a runny nose, frequently have sinus pressure and HAs, I had a CXR done in 2007 when dx with the Erythema nodosum and it was WNL. I was also supposed to have an abd US done last year d/t tenderness to palpation of liver when NP did my yearly physical, but I missed it. I'm just tired of being sick and tired you know?. Thank you for all your help.

Answered by Dr. Satyadeo Choubey (24 minutes later)

Thank again for your follow up.

Since you are from a medical profession, it's my pleasure to guide you.

I think it will be better to go for paranasal sinus imaging, because a block in their drainage pathway can cause recurrent and chronic sinusitis and also if there are nasal abnormalities like deviated nasal septum, hypertrophied turbinates, then also chronic rhinosinusitis can happen.

I feel that you must rinse your mouth after each puff of flonase as this is a known cause of oral thrush or oral muco-cutaneous candidiasis and sometimes esophageal candidiasis. Also, whenever there are oral ulcers, topical boroglycerine mouth paint (as it prevents sticking of the ulcer) along with topical clotrimazole helps rapid healing of ulcers.

It will be better to go for recent chest X-ray to have an idea of recent chest infection, and of course the spirometry to detect asthma.

Best wishes

Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Satyadeo Choubey (3 hours later)

My allergist last fall said I had a mildly deviated septum. I recently had a CT of my sinuses and my new allergist ( had to change because first allergist was out of network ) said that i had a little fluid in left forehead sinus but otherwise unremarkable.

Answered by Dr. Satyadeo Choubey (23 minutes later)

Hi,

Mild deviated nasal septum doesn't need any surgical correction.

Little fluid in forehead sinus (frontal sinus) is a sign of sinusitis.

I think you must take an antibiotic course along with steam inhalation with one or two drops of tincture benzoin to let the fluid drained of sinus. Rest do as I have advised previously.

Thanks,

Above answer was peer-reviewed by : Dr. Raju A.T