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LPR and shortness of breath?
(INTRO) I am writing this to see peoples' experiences with LPR and shortness of breath. There are lots of other issues that I will describe, but it seems LPR is what is causing my main issue so that is what I am focused on. (PSYCHOSOCIAL)- For context I am a 31-year-old single male who lives with their parents and is unemployed. I am severely dissatisfied with life at the moment and am cutting out a lot of information because this post is already a novel (sorry!!!). Here is some background then a few questions at the bottom.
(MENTAL HEALTH) Age 15: Diagnosed with Anxiety and Depression. In my 20s I found out I had OCD and experienced Agoraphobia. I believe I have sensorimotor OCD where I focus on my body too much and it impacts certain bodily functions. The symptoms have changed over the years. Everything from not feeling I could walk right, my arm feeling numb and not knowing where to place it when sitting and other things that I won’t mention so as not to trigger any anxious people. Anxiety caused me shortness of breath as the main symptom. The SOB I felt was different than what I am feeling now to be clear though.
(BEVAVIORAL HISTORY) Age 18: I began to smoke ½ pack of cigarettes per day and marijuana every day. I smoked cigarettes until I was 28 and marijuana until I was 29. The marijuana helped with my anxiety, and I didn’t want to be put on daily benzos as SSRIs did not work. I tried like 8 of them, including SNRIs.
(LPR DIAGNOSIS) Age 28: I had trouble swallowing. This wasn’t the first time- as a teen I had trouble, but a Barium Swallow came up empty. This time I did a similar test and was diagnosed with LPR/Vocal Cord Dysfunction.
(LIFE STRESS) Age 28 & 29: I went through lots and lots of stress. Financial, occupational (let go from my job), family issues etc. I even moved. This was during the pandemic. During this time, I quit smoking because every time I smoked, I felt short of breath and my sides hurt. My sides still hurt to this day when I poke them. I was put on daily Clonazepam during the period I was stressed at my job before being let go.
(SOB FROM SIMPLE TRIGGERS) Age 30- I started to get short of breath when I came into contact with the simplest things: car exhaust, someone smoking a cigarette a hundred feet away. These episodes would last for many hours. The only things that helped were talking to a loved one about it, my anti-anxiety medication (Ativan), or falling asleep and it is better in the morning. However, somehow, I got over it. I think it had something to do with getting checked out by doctors (they said I had light asthma but nothing that could cause what I was feeling). And my psychiatrist also made the point he was taking me off daily benzos and my nervous system is all out of whack. He assured me it was likely just my brain triggering myself as my doctor had told me it’d be highly unlikely that I would be getting physically triggered in the situations I found myself in.
(SOB FROM VERY SMALL AMOUNTS OF FOOD TRIGGERS) Age 31- This is where I am now. I am getting short of breath from the smallest amount of trigger foods: chocolate, soda, citrus etc. This is while being on high doses of Esomeprazole and Famotidine too. I did a 12-week acid free diet and that didn’t seem to heal anything. I have a hiatal hernia so I have to continue on PPIs. The shortness of breath just continues and continues. I try exercises from my therapist, distraction etc. Lots of things. Nothing so far works outside of talking to family, benzo doses as needed, and falling asleep usually waking up feeling better.
(SOME STEPS I HAVE TAKEN) I have raised my bed. Smaller meals. Tried so much. I avoid trigger foods as well, but I have rare moments of weakness. I get overwhelmingly depressed or angry about my life situation (lots of things going on I can’t write for the sake of brevity), and I eat small amounts of trigger foods.
(DIAGNOSES) Does anyone have any insight on this? I have had diagnoses (Rhinitis seemed like guess though) of Non-Allergic Rhinitis, Light Asthma (NO was 18 and 16 was cutoff), LPR/VCD, various stomach disorders, and of course mental health issues.
I believe the LPR is the main issue with my breathing, and I think that anxiety fuels it as well. I eventually was put on a daily benzo before losing my job and I am coming off it extra slow. The issues precede me coming off of it. I had previously come off lower doses of benzos as well and this never happened.
(QUESTION 1; DURING EPISODES) What can I do during an episode? Has anyone had success intervening when it has already started?
(QUESTION 2; PREVENTING EPISODES and LENGTH): Outside of the typical lifestyle changes for LPR, has anyone found a good way to prevent episodes? How long do LPR shortness of breath episodes last for you?
(QUESTION 3; PSYCHOSOCIAL/PSYCHOSOMATIC) Could this all (or most) just be a consequence of severe life dissatisfaction? If so, how can I use that information to stop the symptoms? I am trying to move out of my parents’ home, get a job etc. but other health issues are making me disabled. I am trying though. It is just a lot.
(CLOSING) I could just use some support, education, and tips from people in a similar boat. I thank everyone who reads this in advance.
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So sorry you’re going through all of these things. Sometimes it seems overwhelming. But it will get better. I too suffer with anxiety agoraphobia and other health issues. Have you had a pulmonary function test for sob? I have. Also. I have anemia. Nit severe. But I get shortness of breath from that. A winded feeling. I’m now on iron supplements and vitamin c for that. Have you had a good blood work up?cbc? Etc?
Also other than barium swallow? There are other gi studies you can go for to test your swallowing issues. And there’s a test for gi motility where they place something through your nose while numbed to esophagus to see how much stomach acid you may have. Have you been tested for esophagitis? Also known as Gerd?
Hi there! Sorry for the late response.
I am so sorry to hear you are also having some of the same issues. Anxiety is no joke. Agoraphobia too. I would suggest The Anxious Truth podcast and/or The Panic Attack Workbook by David Carbonell. I think he has written books after that book as well.
I did a Pulmonary Function Test and was told I have "early onset/light asthma" but they determined I might not have an issue because inhalers do nothing for me and scans/examinations show my breathing is normal. The PFT showed my NO was 18 and its supposed to be under 16, but I was told anxiety could caused a false positive when the test shows such a light form of asthma.
I have had low iron but wasn't anemic. Had to get iron injections. Last test my iron levels were actually on the higher end.
I have had bloodwork done many times. There were some things that were higher or lower but overall none were deemed significant.
Hi there!
Quick questions: Does it matter if I get the Gaviscon Advance in liquid form vs tablet form? Is peppermint or aniseed preferable?
My GI said to take it 5 minutes after I eat. Is that also how you go about it? I want to take it whenever I feel the shortness of breath but she simply said 5 minutes after a meal. So maybe if I eat a trigger food, take it 5 minutes after that?
Can you provide a link to an online source you trust for purchasing it? Is it completely unavailable in US stores?
Thank you so much!
Hello: It's been over a year since your post. But, I thought I'd share my thoughts in case it's helpful.
First, one of the other commenters gave the web address for Dr. Jamie Koufman. I highly second this suggestion. Dr Koufman was at the forefront of educating about LPR. She has deep research and clinical experience to back her recommendations. You can gain a great understanding on LPR for free from her books, website and YouTube channel. I think Koufman may recognize shortness of breath as a symptom of LPR.
Second, according to Koufman, the issue with reflux is not just the acid, but Pepsin which is a digestive enzyme that also refluxes. (You can also reflux bile salts.) Even when acid is suppressed or controlled, Pepsin lives in the tissues of the respiratory tract. This includes the esophagus, laryngeal/pharyngeal, sinuses, mouth, and yes lungs. According to Koufman, LPR is often misdiagnosed as allergies and asthma. Pepsin is activated every time there is an acid exposure from incoming food which causes continuing inflammation. Pepsin can be deactivated permanently when exposed to a ph of 8 (I think) or above. Koufman gives her prescription for steps to follow to keep Pepsin and acid down. It is simple, but strict and requires diligence.
Third, I am 68 years old and just recently learned that I have silent reflux resulting in Barretts Esophagus. I did not ever have gastrointestinal symptoms other than very mild constipation. If you asked me a year and half ago, I would have told you I could eat a horse. I did lose my singing voice and have trouble sleeping. I had no idea about nighttime reflux interrupting sleep or LPR. Throughout my entire life, I have had a very mild shortness of breath and slight, low grade anxiety. They are just very subtle sensations. I am a nonsmoker and can hike hill and dale for miles. I always associated the shortness of breath with some postural concerns. I am hyper mobile and possibly have an undiagnosed connective tissue disorder. I have had mild orthostatic hypotension since youth. Looking back, I now believe the breath sensation is related to either the autonomic dysfunction and/or the silent reflux I must have had for decades. Regarding anxiety, mine is very mild and unmedicated. It's plausible that when acids are coming up into the airways your body sends an alarm. Stress and the alarm system create more acid. So, it is a vicious cycle. If you look at an anatomy diagram, the stomach/esophagus area is like grand central station with the heart and many nerves, including the vagus nerve, all running toe to toe. The gut/brain connection is real.
Fourth, many things affect acid production, LES function and respiratory nerves. Viral infections, hormones, foods, stress, medicines and autonomic function can all play a role. Some meds, including some mental health meds, relax the LES. Koufman also talks about nerve damage and some medicines for that.
Finally, if you haven't already, I would encourage you to get an endoscopy. It's good to know if you have h. pylori, a hiatal hernia, gastritis, or esophageal damage. I hope you are feeling better these days. I hope this wasn't took much. I wish I had known these things much sooner. Peace.
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