Gastrointestinal Distress and Breathing Issues: A Patient's Journey

Abdominal bloating and difficulty breathing?

Hello, doctor: I have read many articles, but it seems that no one has the same experience as I do.
Recently, I have seen many doctors, but my symptoms have not improved.
I have been working night shifts for over two years, and one day at work, I suddenly felt a sharp pain in my left chest, so I went to see a pulmonologist.
However, one pulmonologist said I had mitral valve prolapse, while another said I did not have any issues, so neither prescribed medication.
Later, my symptoms changed to gastrointestinal issues.
Initially, I felt tightness in the rectal area, followed by bloating in my stomach.
Sometimes I would feel sharp pains in my stomach or rectum or descending colon, so I went to see a gastroenterologist.
One doctor said I was too thin, which caused my arteries to pulsate and compress, while another said I had gas and prescribed gastrointestinal medication.

Then, about a week ago, I suddenly felt a "tight" sensation in my chest that made me feel a bit dizzy, with slight numbness in my left palm and mild tremors in my right hand.
My family took me to the emergency room, where they performed chest and abdominal X-rays and said everything looked fine.
I was scared of experiencing respiratory distress and fainting (since I am the only one working night shifts at my company).
I then consulted an internist, who said I had a nervous disorder caused by stress, leading to bloating and gastroesophageal reflux.
However, I really don’t understand if "heartburn" is the same as "shortness of breath." I feel confused about which specialty to consult.
Even now, I still experience bloating after eating a little, shortness of breath, and a sensation in my chest that feels like it’s locking up.
I am afraid of fainting and also worried about colon cancer or stomach cancer (I had a fecal occult blood test done two years ago, which was normal).
Is it really that easy to develop these conditions?

a00, 20~29 year old female. Ask Date: 2013/07/30

Dr. Lin Minghui reply Gastroenterology and Hepatology

1.
The typical symptoms of gastroesophageal reflux disease (GERD) include heartburn and acid regurgitation.
Atypical symptoms may include chest pain, a sensation of a lump in the throat, and asthma.
2.
It is recommended to relax and not be overly anxious, while paying attention to dietary habits.
Mitral valve prolapse should still be monitored.
3.
To prevent gastroesophageal reflux, it is important to avoid smoking, alcohol, betel nut, and limit the intake of sweets and greasy foods.
Reduce consumption of cola and other carbonated beverages, avoid eating too quickly, do not lie down immediately after eating, and refrain from eating too late.
Focus on consuming fresh foods, avoid artificial additives, and increase the intake of vegetables, fruits, and adequate hydration.
Establishing good lifestyle habits and engaging in moderate exercise can help keep colorectal and gastric cancers at bay.
Wishing you good health, Dr.
Lin Ming-Hui, Taoyuan Hospital, Department of Health.

Reply Date: 2013/07/30

More Info

It sounds like you are experiencing a complex interplay of gastrointestinal and respiratory symptoms that have been quite distressing for you. Based on your description, it seems that you have been through a series of evaluations and have seen multiple specialists, yet you still feel uncertain about your condition. Let's break down your symptoms and concerns to provide some clarity.

Understanding Your Symptoms
1. Gastrointestinal Symptoms: You mentioned experiencing tightness in your rectum, bloating, and occasional sharp pains in your abdomen. These symptoms can be indicative of several gastrointestinal issues, including irritable bowel syndrome (IBS), which is often exacerbated by stress and anxiety. IBS can lead to symptoms like bloating, abdominal pain, and changes in bowel habits. Additionally, the sensation of tightness could be related to muscle tension or spasms in the gastrointestinal tract, which can occur due to stress.

2. Respiratory Symptoms: The feelings of chest tightness, shortness of breath, and the sensation of your chest being "locked" can be quite alarming. These symptoms can sometimes be linked to anxiety or panic attacks, especially if they occur in conjunction with stressful situations. It's important to differentiate between true respiratory issues and those that may be psychosomatic, where anxiety manifests as physical symptoms.

3. Concerns About Serious Conditions: Your worries about serious conditions like cancer are understandable, especially when experiencing persistent symptoms. However, it is crucial to note that the likelihood of developing such conditions, especially in the absence of significant risk factors or alarming symptoms, is relatively low. You mentioned having a normal fecal occult blood test, which is a good sign.

Recommendations for Management
1. Follow-Up with Specialists: Since you have seen multiple specialists, it may be beneficial to have a comprehensive evaluation by a gastroenterologist who can look at your symptoms holistically. They may suggest further testing, such as an endoscopy or colonoscopy, to rule out any underlying conditions.

2. Addressing Anxiety and Stress: Given that your symptoms may be exacerbated by anxiety, it might be helpful to consult with a mental health professional. Cognitive-behavioral therapy (CBT) has been shown to be effective in managing anxiety and can help you develop coping strategies for dealing with stress. Additionally, mindfulness techniques, such as meditation and deep breathing exercises, can help alleviate anxiety and improve your overall sense of well-being.

3. Dietary Considerations: Keeping a food diary may help identify any dietary triggers that exacerbate your gastrointestinal symptoms. A diet low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) can be beneficial for those with IBS. Also, consider smaller, more frequent meals to avoid overwhelming your digestive system.

4. Physical Activity: Regular physical activity can help reduce stress and improve gastrointestinal motility. Even simple activities like walking can be beneficial.

5. Medication Review: If you are currently on medications for your gastrointestinal symptoms, discuss with your doctor whether these are appropriate for your condition. Sometimes, medications for anxiety can also help alleviate gastrointestinal symptoms.

Conclusion
Your symptoms are likely multifactorial, involving both gastrointestinal and psychological components. While it is essential to rule out any serious medical conditions, addressing the anxiety and stress that may be contributing to your symptoms is equally important. By taking a comprehensive approach that includes medical evaluation, dietary management, and psychological support, you can work towards improving your overall health and well-being. Remember, you are not alone in this journey, and seeking help is a positive step forward.

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