Breathing Issues, Abdominal Pain, and Insomnia: Seeking Medical Guidance

Difficulty breathing, sensation of a foreign body in the throat, dull pain in the right abdomen, chest tightness, and insomnia?

Hello doctor, I have been experiencing long-term sleep deprivation due to staying up late.
Since January of last year, I have had difficulty with my exhalation.
When I exhale, my abdomen contracts forcefully inward at a certain point (similar to the feeling of having a stiff, cramping abdomen after laughing for a long time; it contracts every time I exhale).
I am unable to breathe out naturally like a normal person.
I also experience sharp, dull pain in my right abdomen and rib area, and sometimes in my lower right abdomen, accompanied by a feeling of pressure or discomfort.
I am unsure if this is related to my liver or gastrointestinal issues.
After a year, my condition has worsened; my abdomen contracts forcefully during exhalation, leading to cramping sensations that disrupt my natural breathing rhythm, causing shortness of breath.
Recently, I have also felt a foreign body sensation in my throat, which has affected my sleep, leading to frequent insomnia.
Which department should I consult for examination? I feel that my condition is becoming increasingly severe.

Mr. Tu, 20~29 year old female. Ask Date: 2016/06/14

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
Tu,
1.
Difficulty in breathing and a sensation of a foreign body in the throat may lead clinicians to consider issues related to otolaryngology and thoracic conditions.
Pain and discomfort in the right upper abdomen and rib area may raise concerns about liver, gallbladder, gastrointestinal, or thoracic problems.
Dull and sharp pain in the right lower abdomen may suggest issues with the colon or urinary tract.
Chest tightness should also prompt consideration of cardiac or thoracic issues.
Regarding insomnia, it is essential to consider whether it is caused by internal medicine conditions or anxiety and depression.
When evaluating the overall situation, one should also think about potential metabolic or autoimmune diseases, or possibly a dysfunction of the autonomic nervous system leading to psychosomatic disorders.
2.
Due to the diverse and nonspecific nature of your symptoms, it is challenging to recommend a specific subspecialty clinic for you to visit.
I can only suggest that you find a trusted internist or family physician who can take the time to conduct a thorough differential diagnosis.
3.
Additionally, if you have habits such as smoking, excessive alcohol consumption, betel nut chewing, or drinking coffee or tea, it would be advisable to quit these habits.
Maintaining a regular lifestyle, engaging in physical activity, and if possible, going to bed early and ensuring adequate sleep may help improve your condition.

Reply Date: 2016/06/14

More Info

It sounds like you are experiencing a complex set of symptoms that are significantly impacting your quality of life. Your issues with breathing, abdominal pain, and insomnia could be interrelated, and it's essential to approach this situation holistically.
Firstly, the breathing difficulties you describe, particularly the sensation of your abdomen contracting forcefully when you exhale, could be indicative of several underlying issues. This could be related to anxiety or panic attacks, which can cause hyperventilation and lead to a feeling of tightness in the chest and abdomen. Anxiety can also manifest physically, leading to muscle tension and discomfort in various parts of the body, including the abdomen and ribs.
The abdominal pain you are experiencing, especially on the right side, could be due to a variety of causes. It might be related to gastrointestinal issues such as irritable bowel syndrome (IBS), gastritis, or even gallbladder problems. The sensation of a foreign body in your throat could also be linked to anxiety, as stress can lead to muscle tension in the throat and esophagus, causing discomfort and difficulty swallowing.
Given that you have been dealing with these symptoms for an extended period, it is crucial to seek medical attention. Here are some steps you can take:
1. Primary Care Physician: Start by visiting your primary care physician (PCP). They can perform a thorough evaluation, including a physical examination and a review of your medical history. Your PCP can also order necessary tests, such as blood work, imaging studies (like an ultrasound or CT scan), or refer you to a specialist if needed.

2. Gastroenterologist: If your PCP suspects that your symptoms are related to gastrointestinal issues, they may refer you to a gastroenterologist. This specialist can conduct further tests, such as an endoscopy or colonoscopy, to evaluate your digestive system.

3. Pulmonologist: If your breathing issues persist, a pulmonologist may be necessary to assess your lung function and rule out any respiratory conditions.

4. Mental Health Professional: Given the potential link between your symptoms and anxiety, consulting a mental health professional could be beneficial. Cognitive-behavioral therapy (CBT) and other therapeutic approaches can help manage anxiety and its physical manifestations.
5. Sleep Specialist: Since insomnia is a significant concern, a sleep specialist can help evaluate your sleep patterns and suggest interventions to improve your sleep quality.

In addition to seeking medical care, consider implementing lifestyle changes that may help alleviate some of your symptoms. Regular physical activity, a balanced diet, and stress management techniques such as mindfulness or yoga can be beneficial. Avoiding stimulants like caffeine and nicotine, especially close to bedtime, may also improve your sleep quality.

Lastly, it's essential to communicate openly with your healthcare providers about all your symptoms, including how they affect your daily life. This information will help them make a more accurate diagnosis and develop an effective treatment plan tailored to your needs. Remember, you are not alone in this, and seeking help is a vital step towards feeling better.

Similar Q&A

Managing Severe Insomnia and Anxiety: A Comprehensive Guide

For the past month, I have been experiencing chest tightness and pain. I have undergone an endoscopy, which showed no issues. I have also seen a cardiologist, and everything is fine. I do not smoke or drink alcohol. The symptoms have persisted for a month, with severe insomnia oc...

Dr. Chen Wenyu reply Psychiatry
Hello, based on your description, do you have any idea what might be causing your condition? Identifying the cause is essential for addressing the symptoms. Commonly, stress events can be a factor; however, these stressors are often not something that can be resolved quickly. At ...

Struggling with Unexplained Health Issues: Seeking Effective Solutions

Hello, doctor. I have been experiencing many health issues, but I have encountered obstacles in seeking medical help and have not been able to find the cause of my problems or receive effective assistance. Therefore, I would like to seek your opinion. Since childhood, I have been...

Dr. Lin Wufu reply Internal Medicine
Hello, you may need to schedule a follow-up appointment with the Infectious Disease Department for further examination to determine if there are any physiological issues. Additionally, please measure your body temperature daily to check for fever after experiencing chills and shi...

Understanding Your Mental Health: Coping with Sleep Issues and Anxiety

I'm not sure what's going on. Recently, I've been experiencing almost constant insomnia and vivid dreams, and this has been going on for quite a while. I previously consulted a doctor who mentioned that my sleep quality was poor and prescribed medication to help wi...

Dr. Chen Wenke reply Psychiatry
Xiao Hui: Based on your description, it does seem that there is an issue. However, I still recommend that you consult a physician. Insomnia is often a symptom of various underlying problems, and emotional distress usually has its causes that need to be addressed. It's import...

Understanding Breathlessness and Anxiety: When to Seek Help

This week, I have been experiencing some unusual symptoms. After researching online, I decided to consult a psychiatrist. Recently, I have been having difficulty breathing and chest tightness (requiring deep breaths). At night, my hands and feet become cold. Sometimes, I have a l...

Dr. Liang Sunyuan reply Psychiatry
Hello: It could be a gastrointestinal issue or related to anxiety and panic. I recommend taking adequate rest, adjusting your lifestyle, ensuring sufficient sleep, and engaging in activities that help you relax to see if there is any improvement. If gastrointestinal symptoms pers...