Feeling of Foreign Body in Throat and Breathing Difficulties: Gastrointestinal Concerns

There is a sensation of a foreign body in the middle of the chest below the breast and difficulty breathing?

Hello, Dr.
Yang.
I have had gastrointestinal issues since childhood, often experiencing diarrhea.
I also have a history of obesity.
Over the past two months, I frequently wake up suddenly with palpitations and a rapid heartbeat after falling asleep following dinner.
Occasionally, I experience stomach pain accompanied by vomiting, and lying flat is uncomfortable, which prevents me from getting good sleep; I can only sleep in a sitting or semi-reclined position.
Recently, I have noticed tiny specks of fresh blood in my stool, but I previously had an examination that indicated internal hemorrhoids due to prolonged sitting on the toilet, so I assumed it was just a rupture of the hemorrhoids.
This week, whenever I lie down at night, I have a persistent sensation of a foreign body in my throat.
Swallowing saliva is not painful, and there is no phlegm, but I feel this foreign sensation when swallowing.
My stomach feels strange but not painful, and my breathing continues to be labored, resulting in poor sleep throughout the night.
In the morning, I wake up feeling nauseous, even though I had dinner the previous evening around 7 PM and went to bed after midnight.
During the day at work, I also feel nauseous when eating, and while riding my bike or walking home after work, I sometimes suddenly feel difficulty breathing.
Thank you, Dr.
Yang, for your patience in reading and responding.

Miss Zhou, 30~39 year old female. Ask Date: 2024/01/07

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Hello Ms.
Chou, your condition is likely due to gastroesophageal reflux disease (GERD).
It is recommended that you lose weight, exercise more, and increase your intake of fruits and vegetables.
Additionally, please consult a gastroenterologist for an evaluation and to arrange for an upper endoscopy and colonoscopy.
Thank you for your inquiry.

Reply Date: 2024/01/07

More Info

The symptoms you are experiencing, including the sensation of a foreign body in your throat, breathing difficulties, and gastrointestinal issues, can be quite distressing and may indicate underlying gastrointestinal concerns. Given your history of gastrointestinal problems, obesity, and recent changes in your health, it is essential to consider several potential causes and management strategies.

Possible Causes
1. Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the esophagus, leading to symptoms such as heartburn, regurgitation, and the sensation of a lump in the throat (globus sensation). The fact that you experience discomfort when lying down and have episodes of vomiting suggests that GERD could be a significant factor in your symptoms.

2. Esophageal Motility Disorders: Conditions such as esophageal spasms or achalasia can cause difficulty swallowing and a sensation of something being stuck in the throat. These disorders can also lead to chest pain and discomfort, particularly after eating.

3. Anxiety and Stress: Given your mention of feeling anxious and experiencing heart palpitations, it is important to recognize that anxiety can manifest physically, leading to sensations of tightness in the throat and difficulty breathing. Stress can exacerbate gastrointestinal symptoms, leading to a cycle of discomfort.

4. Obesity: Excess weight can contribute to increased abdominal pressure, which may worsen reflux symptoms and lead to breathing difficulties, especially when lying down. Weight management is crucial for alleviating these symptoms.

5. Food Intolerances or Allergies: Certain foods may trigger gastrointestinal symptoms, including nausea and discomfort. Keeping a food diary to identify potential triggers could be beneficial.

6. Irritable Bowel Syndrome (IBS): This functional gastrointestinal disorder can cause a variety of symptoms, including abdominal pain, bloating, and changes in bowel habits. Stress and dietary factors often play a role in IBS.

Management Strategies
1. Dietary Modifications: Avoiding trigger foods (spicy, fatty, or acidic foods) can help reduce reflux symptoms. Eating smaller, more frequent meals rather than large meals may also alleviate discomfort.

2. Weight Management: If you are overweight, losing weight through a balanced diet and regular exercise can significantly improve your symptoms. Even a modest weight loss can reduce abdominal pressure and improve reflux.

3. Sleep Positioning: Elevating the head of your bed or using extra pillows can help prevent acid reflux during sleep. Avoid lying down immediately after eating.

4. Stress Management: Techniques such as mindfulness, meditation, or cognitive-behavioral therapy can help manage anxiety and stress, which may, in turn, alleviate some of your physical symptoms.

5. Medical Evaluation: Given the complexity of your symptoms, it is crucial to follow up with a healthcare provider. They may recommend further evaluation, such as an upper endoscopy, to assess for esophageal or gastric issues, or a referral to a gastroenterologist for specialized care.

6. Medications: Over-the-counter antacids or proton pump inhibitors (PPIs) may provide relief from acid-related symptoms. However, it is essential to consult with a healthcare provider before starting any new medication.

Conclusion
Your symptoms warrant a thorough evaluation to rule out serious conditions and to develop an effective management plan. It is important to communicate openly with your healthcare provider about all your symptoms, including the sensation of a foreign body in your throat and any breathing difficulties. By addressing both the physical and psychological aspects of your health, you can work towards improving your overall well-being and quality of life.

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