Can’t shake off tight chest feeling despite good peak flow / inhaler use

[LukeM1875]

Mystery catalysts to chest tightness...

I’m 32 and I’ve had asthma most of my life. I smoked in my teens to mid 20s and didn’t look after myself (in terms of prevention/inhalers). Since moving to London a few years ago my asthma has exacerbated. I now look after myself - exercise where possible,use seretide inhaler 4 x day and salbutamol as required. My issue is this:

I have an incredibly tight chest all the time. Inhalers don’t seem to make a difference. My peak flow is good for me (average 600) but the tightness comes and goes for a period of up to 2 weeks - it is a dull burning and feels like I can’t breathe in fully. I’ve had spirometry tests which came back “fine”. Specialists discharged me as technically they couldn’t help further. I know I am lucky relative to many on here. But it is still restrictive - for example I can’t eat/chew food without stopping to take deep breaths in.

Does anyone else have this feeling all the time? Is there anything you’ve found that helps to alleviate it? So far I’ve found alcohol to be a big culprit but the discomfort continues after long spells of not drinking. Has anyone experienced GERD as a proven catalyst?

Thanks you all very much.

[RD23]

Sounds like you’re doing a good job at looking after yourself now.

I’m by no means an expert but just going from my own knowledge and experience, have you seen a respiratory physiotherapist at all? They may be able to suggest various breathing techniques to clear it, mine recommend pursed lip breathing to clear the tightness in my chest. I also find steam helps but it can make people worse so it’s all about what works for you.

Only other thing I can think of is that it could be the sulphites in the alcohol as they can trigger allergic reactions. I don’t drink white wine as I find the next day I have a stuffy nose.

I’d say ask your GP to refer you to a respiratory physiotherapist in the first instance and see if they can help.

[RD23]

Just another thought, it’s not something that has ever affected my asthma so maybe someone else can advise better, but acid reflux can make your asthma worse so could be linked to that.

[LukeM1875]

Thanks a lot RD23!

[RD23 in reply to LukeM1875]

No worries, hope you can find out what’s causing it.

[Hidden]

Yep, I have had asthma my whole life (well controlled, in the summer I dont use any inhalers and I ride 100k per week ) and about 2 years ago after a bad cold I had a continuous tight chest. It seemed different to asthma, it was a continuous and nagging restriction that never went away, where as asthma came on got worse, was helped by inhalers, and then would abate.

Inhalers made only a slight difference, my PF was 550 and I feel the restriction is when inhaling.

The top culprit for me is LPR (silent reflux) this is not like GERD but the list of symptoms is long.

Possibly it could be a vagus nerve issue from a virus and this can be damaged by LPR also.

VCD is a possibility and again can be caused by LPR or allergies.

Lastly would be anxiety.

I have seen a GI and have a hiatus hernia and a ENT who was useless and told me to get used to it!

Next on the list for me is a pulmonologist, i need to sort my private healthcare and book an appointment with my GP.

[LukeM1875]

Thanks Simon and good luck. I wonder if my symptoms are related to the above? Does it feel like your chest is on fire a bit? I had a stomach ulcer a few years back which makes me think it is related to that. Fingers crossed for you.

[Babbela]

I had similar breathing and constant coughing everyday for about 2 years, I thought because it was the outcome of having a acute chest infection which wasn't treated properly until visiting a stand in doctor diagnosed acid reflux and prescribed meds ,since my health has turned a corner Im feeling better no coughing or tightness in my chest hope this helps .

[LukeM1875]

Thanks Babela. I don’t have much coughing but the tightness is doing my head in, would love to follow your lead!

[hilary39]

It’s common to have chest tightness and a normal peak flow / FEV1 spirometry reading as those measure your large airways. With asthma your small airways (which are responsible for most of your breathing) can be quite tight and cause chest tightness. I have terrible asthma and frequent flares but typically have normal peak flow readings.

[LukeM1875 in reply to hilary39]

Thanks Hilary, I didn’t know that!

[Palette]

I have the same symptoms and decided to try Gaviscon in case acid reflux was causing tight chest symptoms, it seems to help. I have been trying to reduce my dependence on Seretide and Ventolin so I was thrilled that just taking the Gaviscon had a helpful effect.

[LukeM1875]

Thanks Palette! Great to hear that. Hopefully I can get the same results!

[Henlen]

I used to have a burning sensation on my lungs not doctors did not believe existed. I found I have a dairy allergy. No dairy for two weeks and my asthma disappeared.