Ongoing breathing issues

[ZM1980]

Hello all, a while back I posted on this forum, with regards to worsening breathlessness (mainly on exertion/incline). I have had chest X-rays, Cardio Pulmonary Exercise test, Spirometry and an advanced lung function test (all of which have been normal, with no evidence of ling disease), however I still continue to experience left sided chest tightness and breathlessness - usually walking upstairs/uphill.

I also keep getting recurrent chesty cough/chest infection type symptoms, that always affect the left side - I get left sided wheezing, tightness, cough and burning sensation in left lung when coughing.

I have been to my GP/seen different GPs on numerous occasions, describing all my symptoms. I have been referred to the respiratory clinic and more recently, Cardiology, as I did have ectopics with the exercise test (and get them frequently) - however, the most recent test (MRI) revealed no inducive ischemia, but symptoms may be due to Microvascular disease (Consultant isn't even sure)!

At the moment, I am unwell with another chest infection/chesty cough, which again is worsening all the left sided symptoms. I have struggled with acid reflux over many years and my main concern is possible lung damage from this/something related. I'm worried there is an underlying condition not diagnosed. Any thoughts/input would be appreciated.

[Shancock]

It sounds like it could be acid reflux related. It can produce frequent chest infections. Are you being treated for it? I think you should ask, actually insist that you get referred to a GI specialist as it sounds like it needs to be investigated with tests, and then correct treatment. There are also surgery options that you can discus with a specilaitist but a GP isn't gong to know enough about this condition. I use Ranitidine and Gaviscon advance it helps I'm still getting Bronchitis but just once this year so far.

[ZM1980 in reply to Shancock]

Hi Shancock, with the reflux side of things, I forgot to add that I have had this investigated (upper endoscopy, colonoscopy, Barium swallow), over the years - I was found to have a loose lower oesephageal sphincter and reflux. I have been taking 20mg of Omeprazole once a day for the past few months, which seems to help with some symptoms, but I still have this left sided reflux/bloating/acidy feeling. Next Gastro appt in December. Currently on Amoxicillin for Sinustitis - doesn't seem to be exacerbating any digestive symptoms, though. Do you take Omeprazole as well as Ranitidine?

[Shancock in reply to ZM1980]

Hi, yes my sphincter is open wide when it should be shut, found on CT scan. I just us Ranitidine and Gaviscon and together they help, not completely stop it. I also had sinus infections ended up having an operation to drain my sinuses in the end. Amox is a bit basic for sinus infections. There are better ones to try, Doxycycline, Clarithromycin or Augmentin are better abs for sinus infections, can have a bit side effects but work very well.

There is an operation called Linx surgery that they can do, I was thinking about it. I put it all on hold but am going to discuss it again next year wen I see the specialist again. But I do have private health care, I'm not sure if it's available on NHS. They can do a Nissan fundiplication though. If you google reflux operations that would bring some up. Also something called Stretta surgery.

Reflux seems to cause lung problems I'm not sure why, I did a spirometry test to make sure my lungs were functioning well, glad to say they are but yes I do worry about the frequent Bronhcitis I get. Also it's very tiring as the cough lasts for 4-5 weeks.

[ZM1980 in reply to Shancock]

Hi, thanks for the info about antibiotics. What symptoms do you get with Bronchitis, aside from cough? I've had about 4 viral/infection type illnesses this year, all starting with sore throat, then moving to the chest. At the moment I have an annoying cough aggravated by food/talking/trying to laugh/bending down (upper left side). Steaming seems to help a bit, as does Aspirin for the aches.

When I saw the consultant at respiratory clinic, I did mention I'm worried about acid reflux affecting the lungs, but she dismissed it and said the epiglottis keeps stomach contents from entering lungs - in my mind I was questioning whether she was just trying to reassure me or if she genuinely doesn't know about/believe all the research! Have you had a lung CT scan?

The Linx surgery sounds like a good option. I'm not sure if it's available on NHS either, think the main procedure is Fundoplication. I've heard of Stretta but not quite sure what it entails.

[Shancock in reply to ZM1980]

I had a lung ct scan as my chest xray showed one of my lungs slightly inflated an the dr said i might hsve bronchiestis anyway the specialist i saw at london bridge said you cant diagnose any condition with an xray an she did a ct scan which showed nothing bad she said my lungs had no damage an were right size etc. It did show the sphlincter very loose though, i did a spirometry to check my lung function an it ruled out any lung condition. She said acid reflux typically causes bronchitis as the acid get into your sinuses (i had chronic sinus infection btw) and that drips into the lungs and bronchial tubes causing chest infections, or making the common cold virus become chesty. Ive since had an operation to drain my sinuses too which has helped.

I believe her shes very good shes been at the big london hodpitals Royal free/Brompton, she only does private work now at London bridge/Lister an Harley St. She referred me to a GI specialist and im thinking about whether to have Stretta (uses radio waves to tighten the sphlincter) or Linx. I will prob decide in the spring.

Wen i get brinchitis it starts like a cold, blocked nose sore throat dry cough. Then wet phelgm cough an a wheeze, lots of mucus. Steam and hot drinks help i cough up phelgm ususlly just clear then i have 7/14 days of abs. Makes me tired ache and chilly. The worst of it is about 2 weeks but the cough an back pain linger for about 4/5 weeks. Im nearly over this one, but not quite.

Also whilst ive got the infection i get very breathless, so use Salbutamol.

I get it every year since i had pneumonia 5years ago. Doxy or clarithromycin are the best abs to clear it up, amox not strong enough. Can get unpleasant side effects though.

[ZM1980 in reply to Shancock]

Hi, yes that makes sense regarding the acid dripping into your lungs. I think my symptoms started about 15 years ago - began with chest tightness when walking. I was originally diagnosed with Asthma, but when I had all the tests at the respiratory clinic (Charring Cross), consultant said results weren't indicative of Asthma.

The consultant you saw sounds good - it makes sense not to use only X-ray as diagnostic, as it's a very basic test. I have asked my GP to re-refer me back to the respiratory clinic, as I want a CT scan, but she just said I should use the steroid inhaler every day and see how things go. I have an appt tomorrow (with different GP) so will discuss this again.

The Bronchitis doesn't sound pleasant - I don't think I've ever had it, but get a lot of symptoms similar to yours, when I get ill - I have noticed I get more chest symptoms these days and takes me longer to recover (steam inhalation helps).

Stretta sounds like a good choice - is your reflux present all the time, or just at certain times?

[Shancock in reply to ZM1980]

I think it would be more often if I didn't take meds for it, it gets very bad if I get a chest infection I think they make each other worse really.

A CT scan can't necessarily diagnose reflux it can go some way to helping if the sphlincter is visibly open like mine was. For reflux you usually then get referred to a GI specialist who does an endoscopy first then sometimes a Barium swallow and or function tests (where u have a small tube go up your nose into your throat to test your swallowing mechanism.

In the mean time you can try Ranitidine (u can buy it in Boots), take it morning and night (30 mins b4 food) and Gaviscon Advance 4 times a day after each meal and b4 bed @ 10ml, (40ml a day).

A GI specialist can prescribe a much higher dose of Ranitidine and/or PPI (like Omeprazole or Nexium). These do take at least a month before they really start to work though.

In addition I also use a saline nasal rinse daily to flush out mucus called Neilmed sinus rinse and drink plenty of warm water. Stay away from caffeine and heavy dairy products they make you produce more mucus.

If relflux is left untreated it can cause all sorts of problems, and yes often people are wrongly diagnosed as having asthma by the GP when it may be reflux instead an the two things are very differently treated. So if a spirometry test has ruled out asthma then I wouldn't have thought steroid inhaler is really going to help you. I'm no doctor but I can't see how it would really.

[Kristicats]

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

[ZM1980 in reply to Kristicats]

Thanks for the link Chriskho, interesting reading - think I may have come across a similar article before in my anxiety-driven online searches! Pulmonary Fibrosis is what's been on my mind/my main worry, as I know that's difficult to diagnose and sometimes only discovered by CT scan (which I haven't had)

[Athame123]

Has your liver been checked? Might be causing acid reflux.

[ZM1980 in reply to Athame123]

Hi Athame123, I had an abdominal ultrasound (earlier this year), no evidence of liver disease. LFT blood tests all within normal range. Endoscopy revealed loose oesophageal sphincter, so think this is the cause of my reflux!

[Spacecat1]

Have they checked your c02 levels I have problems with my breathing and it turns out I am producing to much oxygen. So wear a mask in bed to help.me. check with your GP. Or your consultant will arrange checks. I often got pains and even getting up from a chair was hard. It's worth checking it may be nothing at all to do with your c02 levels. But you have to cover all avenues

[ZM1980 in reply to Spacecat1]

Hi Lizzric, that's interesting, didn't know high c02 levels could cause such issues. What would cause it? I ended up in A&E back in June this year, as had chest pain, high BP and low heart rate (GP referred me). Again X-Ray normal, EGG normal, oxygen levels normal (varying between 97 - 99). BP varied quite a bit, as at GP surgery was something like 154/93, hospital went down to 117/60s. Thanks for your advice!