Mysterious shortness of breath: What has helped you?

@katgts @ashleyh I have allergies and asthma and do allergy shots for many things including my cats, so I thought that was under control. Apparently, it was not, and I would have repeating bouts of excess phlegm that would build up and get stuck in my lungs causing the same pressure and ache in my chest, and then it would turn into a chest infection and get my resting heart rate over 100 beats per minute. The problem seemed to be that the swelling of airways from allergies was preventing the normal clearing of my lungs by the cilia (hair cells) that line the airways to move the mucous. I don't smoke, and smoke causes the cilia to become paralyzed impeding phlegm expulsion. I also have thoracic outlet syndrome which causes tight tissue and fascial restrictions because it prevents proper movement of the rib cage and I do PT for that.

My suspicion is that for @katgts, there may be a fascial restriction that wraps around the esophagus and trachea since these are right next to each other passing through the neck and chest. Something must be restricting the burps. A hiatal hernia can also do this. A physical therapist who does myofascial release work can help if fascia is the cause. A gastroenterologist might be able to figure out if there is a hernia. Lung tissue is also fascia with blood vessels for oxygen absorption, and this fascia is an interconnected web that threads through everything in the body. I have resolved my lung issues with better allergy prevention, and I wear a disposable surgical mask when I'm near my cats, and that works, a good one made by 3M #1820 which is as good as a HEPA filter. I also have several HEPA filters running in my house. I have created a discussion about myofascial release (MFR) with a lot of information. Fascia does not show up on imaging, so these problems go unnoticed, and many doctors are not aware of this type of physical problem, and of course, everything looks normal.

Here are some links-
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/diagnosis-treatment/drc-20353994
https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/
https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/symptoms-causes/syc-20373379

Hey, How did you get your thoracic outlet syndrome diagnosed? @jenniferhunter . My Physical therapist has told me the same thing but I'm going to a neurologist to get a proper diagnosis.

Let me preface by saying that I also have GERD, and during my barium swallow testing an elevated right hemidiaphgram was found where paralysis was ruled out during a sniff test. I'm seeing the neurologist to get the thoracic outlet (nerve) in my left arm, pec, shoulder etc diagnosed as well as do phrenic nerve testing.

I also experience exactly what the OP wrote and can't run either because it feels like i have something constricted down my esophagus which leaves me with an air hunger feeling and when I can not satisfy it creates massive anxiety. I also find myself feeling the need to take deep breaths to satisfy, and have my own conclusion that this may be related to the GERD / LPR especially, if you're speaking of allergies, and if you've done a trans nasal endoscopy and see inflammation in the larynx you can ascertain that its causing "airway reflux / inflammation" and the possiblity of a hiatial or diaphgramic hernia causing the "constriction" like feeling you're left with when experiencing the air hunger.

I also find myself belching ALOT and have noticed that a good way to align this with GERD is to see if you do worse off PPI's or betterr with them. I have seen high dose PPI help with the breathing and air hunger feeling but still haven't dared to run with all other tests coming out perfect. A hiatial hernia can cause a lot of issues as air hunger comes from diaphgramic breathing and if there is a hiatial hernia "getting in the way" this may be the root of your symptoms. I would not down regulate the GERD at all.

I also find when i eat i feel better but then after it starts again. This all leads to reflux whether it be silent or regular. I think people need to pay attention to if their PPI's are helping and if higher doses help like in my case i take 80mg nexium..regardless i'm doing all the tests to get the LINX done.

@justlearning- I want to welcome you to Mayo Connect. I can understand your despair when you can't get enough air and when you feel as if something is caught in your throat. How long has this been going on? What doctors other than a physical therapist have you seen?

Hey there thank you. After doing a lot of research i think its false dyspnea caused by airway inflammation. I can still do the eliptical but not treadmill. I've seen a neurologist who told me i dont have any neuromuscular diseases just mild carpal, and have seen a gastro, pulmonologist etc.

I have also found it easier to breath when leaning forward vs sitting up straight when on the computer, sometimes even resting the bottom of my sternum against a table.
I think its LPR which is a form of GERD causing false dyspnea. if you google psuedo-dyspnea you can find an article by hannah sadaah

a) Esophagitis, or inflammation of the esophagus, is mostly caused by acid reflux, which is the backlash of stomach acid into the esophagus. Whereas the stomach is constituted like the mouth, the esophagus is constituted like the eye. A drop of lemon juice in the mouth tastes good but the same drop in the eye causes a red eye. Similarly, acid in the stomach is well tolerated because the stomach has a thick mucous coat whereas acid backlash into the esophagus burns and causes inflammation or esophagitis.

Esophagitis is like an iceberg, silent in the majority but causes symptoms in a small minority. Unaware, all of us backlash acid into the esophagus many times a day but anti-reflux defenses come to our rescue and wash the acid away. When our anti-reflux defenses fail, we develop esophagitis and some of us develop symptoms.

The common and well-known symptoms of esophagitis include heartburn, indigestion, abdominal pain, cough, chest pain, sore throat, and hoarse voice. A less known but more worrisome symptom is the feeling of shortness of breath, which usually occurs without the other, more common symptoms. Undiagnosed, this false shortness of breath or pseudo-dyspnea may lead to frequent heart and lung investigations and inappropriate treatments.

There are sensory nerve endings in the esophagus that can send false messages to the brain. When the esophagus is burned by refluxed acid, these nerve endings fool the brain into feeling short of breath, as though the lungs were not providing enough oxygen. Reacting to this feeling, the individual takes in deep sighs in an attempt to alleviate the perceived shortness of breath. But, the more and the deeper the sighs, the worse the perceived shortness of breath gets, rendering the individual restless and anxious. This restless anxiety leads the individual to pace or exercise, which temporarily relieves the shortness of breath. When motion ceases and the individual sits or lies down, the shortness of breath returns.

Treatment of this false shortness of breath relies on suppressing stomach acid and coating the esophagus with acid protecting agents. A combination of Omeprazole (or other acid suppressing medicines) plus Simethicone (or other acid protecting medicines) will give prompt relief and reassurance that there is nothing wrong with the heart or lungs.

Esophageal pseudo-dyspnea cannot be diagnosed with tests, examinations, or procedures. This diagnosis is entirely clinical, based on the history alone, and can only be confirmed with a therapeutic trial. Obtaining relief with acid suppressing and acid neutralizing agents confirms the diagnosis and cures the condition.

Hey there thank you. After doing a lot of research i think its false dyspnea caused by airway inflammation. I can still do the eliptical but not treadmill. I've seen a neurologist who told me i dont have any neuromuscular diseases just mild carpal, and have seen a gastro, pulmonologist etc.

I have also found it easier to breath when leaning forward vs sitting up straight when on the computer, sometimes even resting the bottom of my sternum against a table.
I think its LPR which is a form of GERD causing false dyspnea. if you google psuedo-dyspnea you can find an article by hannah sadaah

a) Esophagitis, or inflammation of the esophagus, is mostly caused by acid reflux, which is the backlash of stomach acid into the esophagus. Whereas the stomach is constituted like the mouth, the esophagus is constituted like the eye. A drop of lemon juice in the mouth tastes good but the same drop in the eye causes a red eye. Similarly, acid in the stomach is well tolerated because the stomach has a thick mucous coat whereas acid backlash into the esophagus burns and causes inflammation or esophagitis.

Esophagitis is like an iceberg, silent in the majority but causes symptoms in a small minority. Unaware, all of us backlash acid into the esophagus many times a day but anti-reflux defenses come to our rescue and wash the acid away. When our anti-reflux defenses fail, we develop esophagitis and some of us develop symptoms.

The common and well-known symptoms of esophagitis include heartburn, indigestion, abdominal pain, cough, chest pain, sore throat, and hoarse voice. A less known but more worrisome symptom is the feeling of shortness of breath, which usually occurs without the other, more common symptoms. Undiagnosed, this false shortness of breath or pseudo-dyspnea may lead to frequent heart and lung investigations and inappropriate treatments.

There are sensory nerve endings in the esophagus that can send false messages to the brain. When the esophagus is burned by refluxed acid, these nerve endings fool the brain into feeling short of breath, as though the lungs were not providing enough oxygen. Reacting to this feeling, the individual takes in deep sighs in an attempt to alleviate the perceived shortness of breath. But, the more and the deeper the sighs, the worse the perceived shortness of breath gets, rendering the individual restless and anxious. This restless anxiety leads the individual to pace or exercise, which temporarily relieves the shortness of breath. When motion ceases and the individual sits or lies down, the shortness of breath returns.

Treatment of this false shortness of breath relies on suppressing stomach acid and coating the esophagus with acid protecting agents. A combination of Omeprazole (or other acid suppressing medicines) plus Simethicone (or other acid protecting medicines) will give prompt relief and reassurance that there is nothing wrong with the heart or lungs.

Esophageal pseudo-dyspnea cannot be diagnosed with tests, examinations, or procedures. This diagnosis is entirely clinical, based on the history alone, and can only be confirmed with a therapeutic trial. Obtaining relief with acid suppressing and acid neutralizing agents confirms the diagnosis and cures the condition.

Hey there thank you. After doing a lot of research i think its false dyspnea caused by airway inflammation. I can still do the eliptical but not treadmill. I've seen a neurologist who told me i dont have any neuromuscular diseases just mild carpal, and have seen a gastro, pulmonologist etc.

I have also found it easier to breath when leaning forward vs sitting up straight when on the computer, sometimes even resting the bottom of my sternum against a table.
I think its LPR which is a form of GERD causing false dyspnea. if you google psuedo-dyspnea you can find an article by hannah sadaah

a) Esophagitis, or inflammation of the esophagus, is mostly caused by acid reflux, which is the backlash of stomach acid into the esophagus. Whereas the stomach is constituted like the mouth, the esophagus is constituted like the eye. A drop of lemon juice in the mouth tastes good but the same drop in the eye causes a red eye. Similarly, acid in the stomach is well tolerated because the stomach has a thick mucous coat whereas acid backlash into the esophagus burns and causes inflammation or esophagitis.

Esophagitis is like an iceberg, silent in the majority but causes symptoms in a small minority. Unaware, all of us backlash acid into the esophagus many times a day but anti-reflux defenses come to our rescue and wash the acid away. When our anti-reflux defenses fail, we develop esophagitis and some of us develop symptoms.

The common and well-known symptoms of esophagitis include heartburn, indigestion, abdominal pain, cough, chest pain, sore throat, and hoarse voice. A less known but more worrisome symptom is the feeling of shortness of breath, which usually occurs without the other, more common symptoms. Undiagnosed, this false shortness of breath or pseudo-dyspnea may lead to frequent heart and lung investigations and inappropriate treatments.

There are sensory nerve endings in the esophagus that can send false messages to the brain. When the esophagus is burned by refluxed acid, these nerve endings fool the brain into feeling short of breath, as though the lungs were not providing enough oxygen. Reacting to this feeling, the individual takes in deep sighs in an attempt to alleviate the perceived shortness of breath. But, the more and the deeper the sighs, the worse the perceived shortness of breath gets, rendering the individual restless and anxious. This restless anxiety leads the individual to pace or exercise, which temporarily relieves the shortness of breath. When motion ceases and the individual sits or lies down, the shortness of breath returns.

Treatment of this false shortness of breath relies on suppressing stomach acid and coating the esophagus with acid protecting agents. A combination of Omeprazole (or other acid suppressing medicines) plus Simethicone (or other acid protecting medicines) will give prompt relief and reassurance that there is nothing wrong with the heart or lungs.

Esophageal pseudo-dyspnea cannot be diagnosed with tests, examinations, or procedures. This diagnosis is entirely clinical, based on the history alone, and can only be confirmed with a therapeutic trial. Obtaining relief with acid suppressing and acid neutralizing agents confirms the diagnosis and cures the condition.

@justlearning Thanks for taking the time to write out such a detailed post. I'm constantly going back and forth between whether this SOB is related to anxiety, breathing technique, GERD, or something else. I know a few people, including myself, have been taking anti-acid medicine for a while and still experience SOB. I've personally been on omeperazole for about two months and it's been difficult for me to tell if it's made a difference. I'm currently working to make adjustments to my diet to cut out any items that might be triggering GERD and overpowering the omeperazole. I look for patterns as much as I can... the first instant that the SOB hit me I was drinking a glass of red wine. Then this past Sunday I had a glass of red wine and the next two days were really bad breathing days. This makes me think that the high acidity of the wine can cut through anti-acid medications.