Trying Omeprazole

[Maya_227]

Hi, I was diagnosed as asthmatic 14 years ago after a chest infection that went on for months. I was stable with very few symptoms for 10 years then had a chest infection that triggered my asthma. I wheezed and coughed phlegm for 6 months after. Next winter another chest episode, again took months to feel ok. This has happened for 3 consecutive winters and I now have a permanent phlegmy cough, some days better than others but with no consistent triggers. I have only had 6 weeks clear of coughing in the past 3 years and that was after 2 courses of doxycycline, steroids and doubling my steroid inhaler. I had aspirometry test during that period which was normal. Two days after it my cough/phlegm started up again. I am a healthy weight, exercise 6 days a week and am basically very healthy apart from this blasted cough. I am currently trying omeprazole to rule out silent reflux. Has anyone else suffered from reflux induced phlegm/cough. I sound as if I have bronchitis and have a horrible rattle/bubbling feeling in my chest which is tiring and embarrassing, especially with Covid! I am living in Gibraltar until Xmas and my GP has said they will do sputum samples etc when I return.

[MrsCMK]

Hey! It sounds like you’ve had a rough time lately, I hope things get better for you soon.

I’ve had a similar experience. I have always suffered with terrible reflux but it was only 12 months ago that it was linked to my asthma. My dose of Omeprazole with dramatically increased and my flares of breathlessness were far fewer than they had been.

I rarely get a cough or phlegmy but treating Silent Reflux was a great addition to my treatment

[Poobah]

Hi May. You should see an improvement if your symptoms are caused by reflux after a month on omeprazole. It's not unusual for the lungs to have a bad reaction to ongoing reflux. I would also consider post nasal drip, if your nasal system is dripping down the throat and into the lungs, then that could also be an irritant. A steroid nasal spray, such as Beconase can help with that. Ask a partner or good friend if they notice you sniff alot - you probably won't notice yourself. During the day you will sniff and swallow the nasal drip, but during sleep, that drip can find its way to the lungs.

If you can discount both reflux and drip by the time you see your doctor, then you can discuss more specific treatments for the phlegm. How long was your course of doxycycline? Was the course long enough? Was it the right antibiotic? All things to discuss when you see your doctor.

All the best.

[Hidden]

I’ve had issues with reflux for over twelve years now and it has caused confusion once or twice as symptoms of silent reflux and asthma can be very similar.

I can’t use a PPI (Proton pump inhibitor) which is what Omeprazole, Lansoprazole etc are because I get rebound symptoms when I come off them, not something that affects everyone. I’m currently on cimetidine and gaviscon advance, and I’m awaiting further tests to try and identify what is going on and whether surgery is required (not something I want).

I have learned to tell which condition is causing symptoms of coughing and breathlessness: starting to have symptoms within 30 or45 minutes of eating or drinking something (we know I have no food allergies); Asthma type symptoms at night exacerbated or relieved depending on my sleeping position; and the best one of all symptoms not responding to ventolin but responding to gavision advance is an absolute giveaway.

If they think you have reflux have you been given advice on what foods to avoid, raising the head end of your bed etc?

[Maya_227]

Thank you for the replies. I have never suffered reflux symptoms, indigestion etc (apart from during late pregnancy) but am happy to give the omeprazole the 2 months. I am on week 3 now and I am not rattling or wheezing and my coughing and phlegm production have reduced over the past few days. I am hoping this is due to the medication but I do have good periods and then weeks of constant symptoms so we shall see. Keeping my fingers crossed 🤞

[Hidden in reply to Maya_227]

The condition known as silent reflux is so called because the usual symptoms (heartburn, indigestion etc) are absent. As a result the breathlessness and coughing that often result from it can be mistaken for asthma.

[Tw1nkle]

It was only recently I was told about the possibility of having silent reflux after phoning Asthma UK and speaking to one of their nurses. When I looked up all the symptoms I could tick almost every one. I couldn’t take PPI medication as I found out I was vitamin B12 deficient and PPIs can effect the absorption of B12 but at the same time I joined Weight Watchers, stopped eating late at night and more healthily and propped myself up with another pillow at night and the difference has been amazing. I rarely cough or throat clear now, before I used to get on people’s nerves doing it all the time or have to suppress it. I had been on Montelukast which did nothing for phlegm. I don’t know why the respiratory nurses at my surgery never mentioned this to me, they just kept giving me different inhalers to try, all of which made me worse.

[Hidden in reply to Tw1nkle]

It is very, very easy to confuse the two - the symptoms are so similar. I do now know the questions to ask myself and things to do to determine which of the two is causing the problem but that hasn’t always been the case. There was one occasion some years ago when after a month of struggling with breathlessness I went to see my GP concerned that my asthma was out of control. Actually it was a locum I saw but full credit to him he noticed in my notes that I had history with digestive issues and put that plus the information I was able to give him (breathing issues caused by eating and drinking whilst getting up and walking helping with them, both of which were atypical for an asthma flare in me) and treated me for reflux. Problem solved!

I am now under consultant led care for my digestive issues. This past year has not been great on that front and April/May were horrendous: classic asthma flare symptoms: iron bands round chest, coughing and having huge problems taking anything other than shallow breaths. But my peak flow was fine and ventolin had zero impact. However, the symptoms were flaring whenever I ate or drank something and whilst ventolin didn’t work, taking Gaviscon Advance did bring about some relief. But it wasn’t enough. It took seven weeks on cimetidine twice daily (morning and evening), and Gaviscon Advance twice daily (mid day and just before going to bed) to bring things back under control - and I’m still on both to keep them there, six months later.