Could Your Breathing Issues Be a Sign of GERD Recurrence?

Could the feeling of congestion in the breathing be a recurrence of gastroesophageal reflux disease (GERD)?

Hello, Doctor: Over four months ago, I underwent an upper gastrointestinal endoscopy at a major hospital, and the report indicated severe gastric ulcers, duodenal ulcers, and gastroesophageal reflux disease (GERD).
I was prescribed a four-month course of Pantoprazole, and I have been taking it for four months.
I feel that my stomach has improved significantly; however, in the past month, I have frequently experienced a sour sensation in my throat and occasional feelings of breathlessness, which can occur at any time throughout the day.
Sometimes, I suddenly feel short of breath, as if I can’t get enough air.
These symptoms did not occur during the first three months of taking Pantoprazole, but they have been happening almost daily in the past month.
Each episode is relatively brief and resolves on its own, but my quality of life has diminished.

Could these symptoms be a recurrence of gastroesophageal reflux? I have consulted multiple specialists and undergone various tests: the pulmonologist found everything normal (normal oxygen saturation and no asthma), the cardiologist noted occasional premature ventricular contractions (but they are infrequent), the ENT specialist diagnosed me with rhinitis and post-nasal drip (also no asthma), and the family medicine doctor suggested that it might be related to anxiety or stress.
Despite seeing various specialists, I have not been able to identify the correct cause of these intermittent symptoms.

I would like to ask: (1) If these symptoms could be caused by gastroesophageal reflux leading to the sensation of breathlessness, should I return to the original gastroenterologist for further evaluation? (2) Since I have already undergone an endoscopy and taken Pantoprazole for four months, if GERD has recurred, should I continue with the same medication (Pantoprazole), or should I consider switching to another medication like Rabeprazole, or perhaps another alternative? Thank you for your response.

Mr. Wang, 30~39 year old female. Ask Date: 2016/11/04

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
It is recommended to discuss with your original gastroenterologist whether to continue medication for controlling gastroesophageal reflux.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2016/11/04

More Info

Your symptoms of throat discomfort, occasional shortness of breath, and feelings of tightness could indeed be related to gastroesophageal reflux disease (GERD) recurrence, especially considering your history of significant gastric and duodenal ulcers. GERD can manifest in various ways, including respiratory symptoms, due to the reflux of stomach acid irritating the esophagus and potentially leading to complications such as aspiration or chronic cough.

1. Connection Between GERD and Breathing Issues: The acid from the stomach can irritate the throat and airways, leading to sensations of tightness or difficulty breathing. This is sometimes referred to as "reflux-induced asthma" or "cough variant asthma," where the primary symptom is a chronic cough or wheezing rather than the typical asthma symptoms. The acid can also cause a sensation of a lump in the throat (globus sensation), which might explain the "acid feeling" you describe.

2. Returning to Gastroenterology: Given your recent symptoms and the fact that they have emerged after a period of improvement, it would be prudent to return to your gastroenterologist. They can reassess your condition, possibly perform additional tests, and determine if your GERD has indeed recurred. They may also consider whether your current medication (the proton pump inhibitor, or PPI, you are taking) is still effective or if a different medication might be more suitable.

3. Medication Considerations: If GERD is confirmed to have recurred, your doctor may recommend continuing with the same PPI (like the one you are currently taking) or switching to another one, such as rabeprazole (AcipHex) or pantoprazole (Protonix), depending on your specific needs and any side effects you may have experienced. The choice of medication can depend on various factors, including the severity of your symptoms, your response to previous treatments, and any side effects you may have encountered.

4. Lifestyle Modifications: In addition to medication, lifestyle changes can significantly impact GERD symptoms. These include:
- Dietary Changes: Avoiding trigger foods such as spicy foods, citrus, chocolate, caffeine, and fatty foods can help reduce symptoms.

- Eating Habits: Eating smaller meals and avoiding lying down immediately after eating can also be beneficial.

- Weight Management: If applicable, maintaining a healthy weight can reduce pressure on the stomach and lower the risk of reflux.

- Elevating the Head During Sleep: This can help prevent nighttime symptoms.

5. Anxiety and Stress Management: Since you mentioned that anxiety might be a contributing factor, addressing stress through relaxation techniques, cognitive behavioral therapy, or mindfulness practices can also help alleviate some of your symptoms. Anxiety can exacerbate physical symptoms, including those related to breathing and gastrointestinal discomfort.

In summary, it is essential to follow up with your gastroenterologist regarding your recent symptoms, as they may indicate a recurrence of GERD. They can provide tailored advice on medication and lifestyle changes to help manage your condition effectively. Additionally, consider integrating stress management techniques into your routine to address any anxiety that may be contributing to your symptoms.

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