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    Suggest treatment for GERD and breathing difficulty

Posted on Mon, 17 Jul 2017 in Digestion and Bowels
Question: Other than aspiration, are there any ways by which GERD or GERD complications can cause trouble breathing (esophagitis causing pressure against respiratory system etc.)?
Answered by Dr. Sunil 2 hours later
Brief Answer:
Pathophysiology explained below.

Detailed Answer:
Thanks for query.
See the mechanism behind respiratory problem in patient with reflux is-
When acid from stomach is refluxed back into esophagus it causes irritation of esophageal mucosa lining. This irritation of mucosa lining causes secretion of large amount if mucuos(protective mechanism of body)from the inflammed area.When this mucous regurgitates into throat it causes respiratory problems.
Aspiration is not usually there.Aspiration of mucous into trachea can cause severe infection.So its not aspiration rather its due to secretion of large amount of mucous by inflammed esophagus.

Above answer was peer-reviewed by : Dr. Remy Koshy
Follow up: Dr. Sunil 1 hour later
Dr. XXXXXXX my grateful thanks for the information.

Follow up questions:

I. If this mucus is not getting into the respiratory via aspiration, by what anatomical and physiological mechanism does such mucus cause breathing trouble? II. If this mucus is not getting into the respiratory system via aspiration, is the resulting breathing trouble harmless, or can such breathing trouble be harmful and possibly dangerous?
Answered by Dr. Sunil 2 hours later
Brief Answer:
Follow up answer.

Detailed Answer:
Hi there ,
See the thing is that if esophagus is producing very large amount of mucuos(significantly large) then there is possibility that some amount of it can get into respiratory tract(as both pipes esophagus and trachea are lying next to each other).

But again its not going to cause significant respiratory distress as body would use its gag reflux to throw the mucous out.
If you are having significant breathing problems initially you should for lungs auscultation by stethoscope and a chest X ray.It's very likely that problem is due to infected lungs as even mild amount of mucous can also cause severe chest and lungs infection.

Yes breathing trouble should never be neglected and baseline tests to rule out possible respiratory infections should be done asap.I hope you can understand the fact that i can neither examine you no can auscultate you so to give you a proper diagnosis i need reports of these tests.

Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Sunil 33 hours later
Dr. XXXXXXX thank you for your response.

Below in text are some recent lab abnormalities, of particular note being the myeloperoxidase and proteinase-3 antibodies, which are suggestive of Wegener's granulomatosis. My providers are not certain what to make of these antibodies as I do not have nose bleeds or blood in urine as is usually typical of Wegener's, though I do have respiratory and sinus involvement typical of such. And attached is somewhat recent spirometry data. Of note: (a) spirometry results dated 11/02/2016 (FEV1/FVC 0.55, FEV1 50% predicted) were qualified as immunologist as "severe obstructive breathing pattern"; (b) complete PFT dated 12/16/2016 could not be regarded as useful data because my obstructive breathing prevented me from taking big enough breaths for test; (c) pre- and post-bronchodilation last month w/ albuterol sulfate rescue inhaler indicated no breathing improvement whatsoever, and albuterol never helps open my airways. Other data: High resolution CT scan of chest in 11/2016 showed no lung infection and no interstitial disease though breathing trouble was severe then; I have a long history of elevated EOS, GERD, and a hiatal hernia; I have an incisional umbilical hernia; I have had dysphagia for a year to the degree my throat above my sternum feels very tight and it is hard to move my neck; I have a long history of toxic mold exposures and consequent mold allergy and mold toxicity (mycotoxicosis), which causes widespread inflammation in the body.

Myeloperoxidase antibodies: 1.9; H (< 1.0 = no antibody detected)

Proteinase-3 antibodies: 1.9; H ((< 1.0 = no antibody detected)

Complement, Total (CH50): > 60 U/mL; H (standard range 31-60 U/mL)

DNA (DS) antibody: 5 IU/mL; H (< or = 4 negative; 5-9 indeterminate; 10 = positive)

Chromatin AB: 1.1 IU/mL; POS AI (< 1.0 NEG AI)

ANA CHOICE ABS CASCADING RFX: positive (standard range: negative)
Answered by Dr. Sunil 19 hours later
Hi again dear patient,
Most likely your problem is related to your immune and respiratory system.
Most of these details are not covered in gastroenterology.
A better suggestion can be given by a respiratory medicine doctor so please follow up with the concerned speciality.
In case you need any further information related to gastroenterology i would be happy to answer.

Above answer was peer-reviewed by : Dr. Kampana
Answered by
Dr. Sunil


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