Managing Long-Term Nighttime Asthma and Abdominal Pain: A Patient's Journey

Chronic nocturnal wheezing and abdominal pain?

I have suffered from asthma since childhood, but I did not experience any relapses around the ages of 13 or 14.
I also have allergic rhinitis, which often leads to sinusitis.
Since being diagnosed with nasal polyps in 2001 and undergoing polypectomy, the incidence of my symptoms has significantly decreased.
However, four years ago, I began to experience mild wheezing at night.
Initially, I did not think much of it, but I have since had bronchitis flare-ups two to three times a year.
In dusty or confined spaces, I clearly feel shortness of breath.
Sometimes, if I accidentally choke on water or laugh too hard, it triggers an asthma attack that takes one to two hours to subside.
After further diagnosis and blood tests, dust mites were identified as the allergen.
Consequently, both my specialist and primary care physician have prescribed long-term use of "Synchloramin." Initially, I only took it during asthma episodes, but as nighttime wheezing became more frequent and severe, I found myself waking up with difficulty breathing, requiring two to three hours to stabilize.
Now, I take it every night from Monday to Friday before bed.
Each time I wake up with nighttime wheezing, I produce a lot of phlegm.
Even after taking Synchloramin, I still wake up with excess phlegm in my throat.
Each asthma episode is accompanied by abdominal bloating, pain in the epigastric region, and discomfort in the lower left chest.
These ailments cause me significant distress and severely hinder my normal life.
I have sought help from various renowned Western and Chinese doctors and specialists, but to no avail.
I have requested my primary care physician and specialists to arrange for hospitalization for further examination, but my requests have been politely declined.
I am now considering seeking private hospitals or specialized health check-up companies for an assessment.
To better understand my condition, I would appreciate any guidance on the necessary tests I should undergo.
Thank you for your assistance.

Chuan Wang, 20~29 year old female. Ask Date: 2009/05/25

Dr. Chen Jianzhi reply Otolaryngology

Dear Inquirer,
Hello, based on your literal question, your issue is indeed quite complex, and many of the descriptions are atypical, making it difficult to determine the specific condition.
I would like to suggest that you visit our outpatient clinic for a more thorough understanding, after which I can recommend the appropriate health examinations.
I recommend visiting the Taoyuan Hospital of the Department of Health on Wednesday afternoons or Thursday mornings.
Sincerely,
Dr.
Chen Chien-Chih,
Physician at Taoyuan Hospital of the Department of Health,
Lecturer at Fu Jen Catholic University

Reply Date: 2009/05/25

More Info

Managing long-term nighttime asthma and abdominal pain can be a complex journey, especially when multiple symptoms and triggers are involved. Based on your description, it seems that you have a history of asthma and nasal allergies, which have evolved over the years, leading to nighttime symptoms and abdominal discomfort. Here’s a comprehensive approach to understanding and managing your situation.

Understanding Your Symptoms
1. Asthma and Allergies: Your history of asthma, particularly with nighttime symptoms, suggests that your asthma may not be well-controlled. Nighttime asthma is often triggered by allergens, irritants, or even gastroesophageal reflux disease (GERD). Dust mites, which you identified as a trigger, can exacerbate asthma symptoms, especially in poorly ventilated or dusty environments.

2. Abdominal Pain: The abdominal pain you experience, particularly when associated with asthma attacks, could be related to several factors:
- Gastroesophageal Reflux Disease (GERD): Asthma and GERD often coexist. The acid reflux can irritate the airways, leading to asthma symptoms. The pain you feel in your abdomen and chest may be related to acid reflux, especially if it worsens after eating or when lying down.

- Muscle Strain: Frequent coughing during asthma attacks can lead to muscle strain in the abdominal area, causing discomfort.

- Mucus Production: The increased mucus production during asthma attacks can lead to a sensation of fullness or pressure in the abdomen.

Recommended Actions
1. Consultation with Specialists: Since you have already seen various specialists, it might be beneficial to consult with an allergist and a pulmonologist. They can provide a comprehensive evaluation of your asthma management and allergy triggers. A gastroenterologist may also be helpful to rule out GERD or other gastrointestinal issues.

2. Diagnostic Tests:
- Pulmonary Function Tests: These tests measure how well your lungs are working and can help assess the severity of your asthma.

- Allergy Testing: Skin or blood tests can identify specific allergens that trigger your asthma.

- Gastroesophageal Reflux Testing: If GERD is suspected, tests such as an esophageal pH monitoring or an upper endoscopy may be recommended.

- Imaging Studies: A chest X-ray or CT scan may be useful to rule out any structural issues in the lungs or abdomen.

3. Medication Review: It’s crucial to review your current asthma medications with your healthcare provider. Long-term control medications, such as inhaled corticosteroids, may be necessary to manage your asthma effectively. Additionally, if you are experiencing significant nighttime symptoms, a reassessment of your medication regimen is warranted.

4. Lifestyle Modifications:
- Allergen Avoidance: Implement measures to reduce dust mites in your home, such as using allergen-proof mattress and pillow covers, washing bedding in hot water, and maintaining low humidity levels.

- Dietary Changes: If GERD is a concern, consider dietary modifications to avoid trigger foods (spicy, fatty, or acidic foods) and avoid eating close to bedtime.

- Sleep Position: Elevating the head of your bed may help reduce nighttime reflux and improve breathing.

5. Monitoring and Follow-Up: Keep a symptom diary to track your asthma symptoms, triggers, and any abdominal pain. This information can be invaluable for your healthcare providers in tailoring your treatment plan.

Conclusion
Managing your asthma and abdominal pain requires a multifaceted approach that includes proper diagnosis, medication management, lifestyle changes, and regular follow-up with healthcare providers. It’s essential to advocate for your health and seek the necessary tests and treatments to improve your quality of life. If you feel your concerns are not being addressed, seeking a second opinion or consulting a specialist in a private setting may provide you with the answers and relief you need. Remember, effective management of asthma often leads to a significant improvement in overall well-being, including alleviating associated abdominal discomfort.

Similar Q&A

Asthma or Autonomic Nervous System Disorder: Understanding Your Symptoms

Hello, doctor. I have asthma due to family history (my grandfather had asthma), but under the misconception that I no longer had asthma symptoms after middle school, my parents didn't let me use a dry powder inhaler, fearing the effects of medication. For over ten years, I h...

Dr. Yang Wenda reply Pulmonology
Hello: Your symptoms still resemble asthma. The pulmonary function test showed improvement in symptoms after inhalation of a short-acting bronchodilator. The report can be further interpreted by your physician. The difficulty in breathing affects the autonomic nervous system as a...

Overcoming Anxiety: Managing Palpitations and Breathing Difficulties

Hello, I have recently been seeing a psychiatrist who diagnosed me with somatic symptom disorder due to anxiety stemming from physical ailments. The doctor prescribed me Anxiolytic tablets and Beta-blockers to be taken after meals, as well as Shurmen and Liyou enteric-coated tabl...

Dr. Wu Enliang reply Psychiatry
Hello, internet user: Please do not worry. Sometimes it is normal to feel fear, but this is just a part of the anxiety disorder. It's important to understand that this will not lead to any physical sequelae or death. These psychosomatic symptoms can improve with proper treat...

Managing Severe Allergies and Asthma: Insights on Immunoglobulin Therapy

I apologize for the lengthy question, but it has been troubling me for a long time. I was diagnosed with severe allergies and severe allergic asthma in childhood. After years of treatment, although my allergy symptoms are still difficult to manage, my asthma has been controlled (...

Dr. Yang Wenda reply Pulmonology
Hello: Some special medications have regulations for health insurance coverage. Typically, these are for patients with severe allergic conditions who have reached the maximum dosage of existing medications without a reduction in asthma attacks. You may consult your attending phys...

Chronic Abdominal Pain: Understanding Complications and Treatment Options

Hello, doctor. Since February of last year, I have been experiencing abdominal pain every night, and sometimes I have to rush to the bathroom in the middle of the night. At that time, my bowel movements had a fishy odor, the color was abnormal, and they were not well-formed. Howe...

Dr. Chen Shidian reply Gastroenterology and Hepatology
If the weight is normal, irritable bowel syndrome (IBS) may be the most likely cause. In addition to using gastrointestinal medications for management, a stool occult blood test can be conducted. If necessary, a referral to a mental health specialist may help with anxiety control...