First asthma, then acid reflux, now eczema. What next?

[Limefime]

Since end of September I have been struggling to get/keep my coughing (CVA) under control. Had 2 bouts of Pred. Changed inhaler to Fostair.

Had blood tests and ECG and doc says I am as healthy as a horse. Suggested I have silent acid reflux and prescribed omeprazole which stopped the night time coughing and constant need to clear my throat. Still coughing on and off though it is much improved.

I had eczema on my eyelids a couple of months ago, which kept coming back in fairly mild bouts, but cleared with hydrocortisone cream and diprobase.

Before I started the omeprazole (so pretty sure it wasn't the trigger) the eczema flared up - first eyelids, then neck and décolleté, now other parts of my face too (chin and under eyes). Been applying the usual hydrocortisone and diprobase but my face and neck are still red and burning like fire.

Since end Sept I have also done a 6 weeks exclusion diet for triggers identified through an allergen test on strands of hair (I know. My friends with medical background do roll their eyes. And it did prove to be wildly off the mark and had no effect when I stopped eating the suggested culprits nor when they re-introduced.) When I saw the doc who suggested I may have acid reflux, she suggested a dairy exclusion diet as the next step in eliminating triggers for the cough/reflux... At that time the eczema was not an issue.

What would you do next if you were me? I guess it is back to the doc and back to the drawing board? I am so discouraged about my health right now...

I did have a very stressful last year and lost both my parents 13 months apart. I read that stress doesn't cause asthma/reflux/eczema but may aggravate it. Sigh.

[HungryHufflepuff]

I’m really sorry to hear you’re having such a difficult time, and sorry for the loss of your parents. My dad passed away recently, quite suddenly, and I’m still devastated. I don’t know why reflux seems to accompany respiratory problems yet it’s apparently one of those things that are part and parcel of it. Just a few weeks ago I started using Slippery Elm, it’s a natural remedy so no interactions with your other medications. And no known side effects. It does help, and you can use it as needed rather than as a course of medication. I bought the capsules, you can get a powdered version and make a gruel but it sounds disgusting! I had Fostair for six months this year which caused all kinds of problems for me, including horrendously itchy skin, but as your problems sound like they started before you were changed onto fostair it’s probably not that which is causing your problems. I hope things start to improve for you soon.

[Limefime in reply to HungryHufflepuff]

I am so sorry about your dad, HungryHufflepuff. The shock of sudden death should not be underestimated. Allow yourself to process that as well as the grieving. Be kind to yourself. And it takes time to adjust to the "new normal". I don't think one ever gets over the death of a loved one... Sending a warm, comforting hug your way.

I think what is making me feel so despondent is that everything seems to be interrelated and difficult to isolate/diagnose. And one thing leads/may lead to another, in both symptoms and diseases.

I have heard of slippery elm. The only problem with treating when symptoms appear is that I have no indigestion or heartburn, ie no symptoms... hence the "silent" reflux. Yeah, never thought it was possible but apparently it is a thing. How do I treat symptomatically if I don't have obvious symptoms?!

I am wondering if I should not start with trying to find out if I have a food intollerance, using a proper medically recognised allergen test. From what I've been reading, it seems that all these ailments could have been triggered by an allergic reaction.

[HungryHufflepuff in reply to Limefime]

Thank you. I hope you can get to the bottom of all your problems. Getting an allergen test seems a good place to start. Hopefully it can happen soon. Having a whole host of ailments is exhausting after a while. Best wishes to you 🤞

[Happy-51]

Hello and sorry you’re having a rough time, the stress and loss of your parents won’t have helped.

Ive been really rough with my brittle asthma since August. Which has meant seeing a cardiologist, stomach doctor and new asthma specialist.

I would say first call for you is proper allergy testing. It’s hard when you don’t have symptoms with the reflux as I just note what’s making it worse and avoid. However checking for allergies I think for you is important.

We all get despondent it’s hard not too.

I’ve only just been able to get my daily steps up from 2-3000 to double that. So shows you how little I’ve been able to do. And it does get you down.

You’re clearly going through an extra allergic/sensitive stage so watch everything you use on your skin.

Had eczema since I was a baby and find I can control it to a certain extent by avoiding a lot of triggers.

[Limefime in reply to Happy-51]

Thanks, Happy-51 (love the pseudonym!). Yes, identifying triggers is difficult for me. I know that cold air triggers my asthma cough but I can't identify any further ones as there isn't a clear cause and effect. As for acid reflux and eczema, I have no idea.

I have given up using any of my normal skin care products and only use diprobase and hydrocortisone cream at the moment.

I am glad that you were able improve your activity levels. I am quite fit generally as I, thank goodness, got my weight under control and joined a gym a good 7 years ago. Unfortunately it also means that there is nothing that I can do in that area to improve my condition(s)...

[Happy-51 in reply to Limefime]

You will, it will just take time.

I’ve been on large doses of steroids nearly my

Whole life. I need to get weight off.

It’s a catch 22

[Yellow75]

I've just been prescribed the omeprazole for acid reflux. Didn't think I had a problem with this either. Not noticed any side effects though. Spoke to my mum and sister who are asthmatic too and they weren't surprised with this latest med of mine.

I think stress can contribute to asthma. Hope you do feel better soon.

[Limefime in reply to Yellow75]

Thanks Yellow75. Hope you are better soon too.

The omeprazole did make me quite lightheaded and nauseous in the beginning (better now), but it is the increased risk to osteoporosis (calcium, magnesium and sodium depletion) and bacterial diarrhoea, amongst others, that one can develop with long term use that scared me. Best not to google the side effects of medicines, me thinks.

[Yellow75 in reply to Limefime]

I did Google a bit, because of depletion in vitamins of it and steriods I am taking in general I am trying vit supplements with potassium,magnesium, calcium, phosphorus rous and also Vit D. I know from tests done recently that I am borderline with Vit D. I do think it's bit hit and miss with asthma meds though, which I don't think is great.

[Limefime in reply to Yellow75]

I agree... There is no hard and fast rule for any aspect of it!

[Hidden]

PPIs, omeprazole, is of little use in treating silent reflux (LPR).

ncbi.nlm.nih.gov/pmc/articl...

My guess is that your cough and possibly asthma symptoms are down to LPR.

A huge driver of reflux is stress and once its symptoms have taken hold it is very hard to get rid of them.

[Limefime in reply to Hidden]

Oh dear... That doesn't sound very encouraging...

[strongmouse in reply to Limefime]

I take Zantac (ranitidine) for oesophageal reflux and find that helps. I have various food allergies and intolerance and it does help to identify these. I find coffee in large quantities aggravates reflux.

I can identify with trying to work out what helps when you have more than one conditions. Try reading around and then making changes a step at a time - list possible things to try by priority 1) 2) 3) etc.. If you try too many at once you won't necessarliy know which ones really are helping. All the best.

[Birthday60]

Fostair caused me to have an eczema flare up . Acid reflux caused my cough - Scan of my lungs show I am good and my peak flow and other lung tests show my asthma was not the problem! Ompreprzole was not great so would suggest you push for alternatives

[pen5377]

I too have asthma and silent reflux. The "silent" tag is there I believe because of the lack of heartburn, the classic symptom of reflux. But that doesn't mean no symptoms, just not that particular symptom which is pain from the oesophagus. You might be told if you had a camera investigation of your voice box, as I have had, that your vocal chords are inflamed by the reflux, that's my main symptom. So a PPI (such as omeprazole) should help, plus avoiding triggers - culprits often include citrus fruit/juices for example. A good way to identify culprits is to keep a daily diary of all the foods and drinks you consume and rate your voice 1-10 and other symptoms such as throat clearing, and try cutting items out and seeing if you have an improvement. Different triggers affect people differently. I found the British Voice Association helpful, it has a section on reflux and your voice. I've been very fortunate in being referred to a specialist Speech Therapist, who was the one who suggested the food diary. It is worth trying to get a handle on it - I think I trundled on quite happily with a PPI for a number of years before I had a marked deterioration in symptoms, hence further investigations, additional medicines (Ranitidine, peptac liquid) and Speech Therapy. I wished I had tackled dietary issues earlier.

Best of luck, and hope your stress eases; bereavement does take its toll on your physical health, so try and be kind to yourself.

[Limefime in reply to pen5377]

Pen5377... you just mentioned something that has been giving me issues for years: my voice keeps disappearing or getting quite croaky for no reason. And as soon as there is even a hint if a cold virus flying past me, the voice goes! I always put it down to straining my voice in my years as a teacher and adult trainer. Never thought it might be related to acid reflux.

A food diary is a good idea. I kept one when I lost weight a good couple of years ago, so I am quite ready for that (after Christmas 😉). I can check/monitor voice quality.

Just developed a very nasty infection on a sore on the inside of my knee too. Really nasty and getting bigger in spite of 3 days of looking after it. It feels like I am falling apart physically. Emotionally not that far behind either...

[Hidden in reply to Limefime]

Other things you need to consider for reflux: raise the head end of your bed by about 5/6 inches (gravity is a wonderful thing and this helps to keep stomach contents where they belong during the night). Also make sure you eat your last meal of the day at least three hours before you go to bed, and make sure you do not slouch or bend over for at least an hour after you have eaten anything. Sitting upright is a really good idea.

I didn’t get on with omeprazole (made me very constipated - admittedly I’m naturally rather prone to that anyway) so my GP switched me on to lanzoprazole - a different PPI - which certainly helped.

I still have reflux issues, but they are much better than they used to be and I am now able to control it with gaviscon advance, being careful of what, when and how much I eat, and having the head of the bed propped up:-).

[Limefime in reply to Hidden]

Thanks for the advice, MaggieHP.

I had vertigo in the beginning of the year and the propping of the bed came up for that too... I don't think the hubby is amenable to that idea! I am looking at buying a wedge pillow so that I can prop myself up at night.

I don't eat for at least 2 hours before bed time (at the moment at least) as I am on antibiotics that needs to be taken on an empty stomach. It is not easy with Christmas and all the eating associated with the festivities.

I just noticed that the omeprazole is not on repeat. In the new year I'll seriously look at identifying triggers and an omission diet to see if it can be managed without medications. I am taking more pills than most 90 year olds!

[Hidden in reply to Limefime]

Sorry to say this, but last meal two hours before. bedtime will probably not be long enough. I’ve refluxed an egg sandwich (so a light lunch and easy to digest) nearly three hours later whilst lying down briefly. When my reflux was at its worst I actually left four hours between evening meal and bedtime even though the head end of my bed was raised.

No it’s not easy at Christmas. I haven’t had Christmas pudding or christmas cake for years. Likewise chocolate (unless it happens to be white chocolate which doesn’t contain caffeine - a known trigger). Likewise red wine as that contains tannin- which we know my stomach doesn’t approve of. For a number of years I couldn’t have roast potatoes, though things have improved to the point where I can have those in small quantities now. But quite frankly, going without was easier to cope with than the discomfort from the resulting from reflux if I indulged.

[Limefime in reply to Hidden]

I am also sorry you had to say this! 😁

But seriously, I am struggling to get a hold on all the things I need to do to keep at bay the acid reflux (that I can't tell I have) and cough asthma (while I can't tell an asthma cough from an acid reflux cough from a cold cough), the eczema and current bacterial infection. I am struggling with my emotions, stress and tears. And with keeping my eating under control at Christmas when every moment someone is offering me "forbidden foods"! I don't know what is hitting me at the moment as it has all come to a head in the last 3 months! I am a healthy individual (normally).

There. All my innards spilled.

I have self-referred to a counselling service near me, which very helpfully has a health team who, from what I gather, looks at your emotional well-being in context of health issues. Of their list of ailments, I only have asthma but hopefully they'll be able to help me holistically. First contact is on the 3rd of January. Fingers crossed.

[Hidden in reply to Limefime]

You’re not alone in not being able to tell an asthma cough from a reflux cough from a cold cough - you really are not. I used to find that difficult; I think a lot of us do at first. These days I can usually tell when reflux is responsible for breathing difficulties, the giveaway being that it always comes on within thirty to forty five minutes of me eating or drinking something.

It is devastating at first. I shed tears of misery when going through the worst of it, so you’re not alone there. However, I did keep reminding myself that there were positives: less fatty foods and chocolate, my skin was likely to approve of that (and did) and I was unlikely to become overweight, which given that I was perimenopausual at the time was also gratifying. And yes, you do wonder what is hitting you, I wondered that too.

You asked what you should do. In your position I would request referral to a gastroenterologist. I’m now under the care of one who does specialise in upper GI tract and he is very understanding of the issues I’ve had. He also referred me to a dietician to come up with a plan as far as foods were concerned - which was also very helpful.

[Limefime in reply to Hidden]

Thank you, MaggieHP, for that reminder that I am not unique in this struggle. I know it, of course, but it does sometimes feel like I am the only one not coping well. So it is good to be reminded I am just like most others and there is light at the end of the tunnel.

I am going to ask for a referral. Not likely that I'll even see my GP before the New Year, but I'll at least have a direction in which to go/ask for when I get there. I think I may need help with a new diet too.