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Q. I am taking deep breaths often and it gets worse after eating. Why?

Answered by
Dr. Aleph
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 28, 2020 and last reviewed on: Jun 06, 2020

Hello doctor,

I am having difficulty in breathing. It is like I always need to take deep breaths. And I think it gets worse after I eat. On top of that, it triggers an anxiety attack most of the time. Another thing is, there is this sensation in my chest, I do not know if is right to call it as tightening or pressure. Usually, when I stand up it somehow alleviates that sensation but the breathing difficulty is still there. Sometimes all of the symptoms go away like for hours but then it comes back. I think I am having these symptoms for three weeks or a month now. I am doing self-diagnosis and I do not really know which of these is it, costochondritis, angina, GERD or COPD. That is why now, I am seeking the help of a professional. I just hope it is nothing serious.

Dr. Aleph

Family Physician General Practitioner
#

Hello,

Welcome to icliniq.com.

Do you have any other symptoms like cough and colds, history of trauma, fever, body aches, diarrhea, or throat pain?

When did you feel tightening or pressure in the chest area, any numbness or weakness in the left arm? Do you feel any burning sensation at the epigastric region (just below your sternum, part of the upper abdomen)? Will you do frequent throat clearing? You also mentioned it gets worse after eating, what food usually triggers it? Do you experience bloatedness or frequent flatulation? Does it get better when you burp or flatulate? Have you tried any medication? Do you smoke? Did this happen before?

Perhaps the anxiety is due to the uncertainty or fear that it might be related to COVID? But based on what you have described so far, it is highly unlikely. I understand the ECQ does not really help and a lot of people are also having the same issue. When we confine ourselves within the premises of our home for this long it takes a lot of things from us. The quarantine has taken our slight sense of freedom, control, and changed it to what we know now as the new normal. But please understand that it might take sometime before the quarantine is lifted but know all of these things are only temporary.

So far, your symptom is pointing to dyspepsia (umbrella for Gerd, hyperacidity, etc). But I need answers to some of the questions mentioned above in order to strengthen the diagnosis.


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Thank you doctor,

As far as I remember I do not have cough and colds, history of trauma, fever, body aches, diarrhea, or throat pain. Well, very few times when I get the tightness feeling on my chest my stomach hurts as well and I need to go to the bathroom. My stool is fine not the watery type. Sometimes the tightness and the breathing difficulty goes away with it. Most of the time it does not.

No, I do not feel any numbness or weakness in the left arm. I do not feel any burning sensation at the epigastric region just below my sternum, or in the upper abdomen. No frequent throat clearing. And almost all foods trigger my condition.

I do not experience bloatedness but I feel super full after taking food and I get better when you burp or flatulate. I have not tried any medication and I do not smoke. What I am really concerned about is the need to always take deep breaths. I mean like, right now, as I am typing this, I do not feel any tightness in my chest but I still take deep breaths like every 5 normal breath I take 1 deep breath, then after 3 normal breath I take 1 deep breath which I think is not normal. Worse case scenario, I experienced is I take deep breaths after every 1 normal breath and it usually happens after dinner. Also, maybe I forgot to tell you this but sometimes while I sit, there are certain positions where I feel something is on my chest. It is not really painful and I cannot really describe it.

Dr. Aleph

Family Physician General Practitioner
#

Hello,

Welcome back to icliniq.com.

Based on what you have disclosed, the symptoms are due to your anxiety attack but the diagnosis of dyspepsia is still apparent. It is alright to take a few deep breaths. Try to do that every morning for a full minute. The difficulty in breathing in surmise is probably brought about by the fact that you are more hyperaware of your symptoms. And this leads to a feeling or sensation of worsening of symptoms or something is wrong that results in the difficulty of breathing and then leads to other things. Hence, the feeling of anxiety.

Let us treat medically, both the anxiety and dyspepsia and follow up after two weeks and do a symptom diary. When doing a symptom diary, take note of your symptoms to include duration, triggers, and action taken. Include your thoughts and feelings, what worries you, what did you feel, etc. Is your weight really just at 39 kg? Or is it 88 kg?

I would also like to suggest the diagnostics: (when you have time, not urgent).

1. 12L ECG (electrocardiography).

2. CBC (complete blood count).

3. TSH (thyroid-stimulating hormone), FT4.

4. CXR-PA view (chest x-ray).

Take Propranolol 10 mg, one tablet three times a day as needed for anxiety, Pantoprazole + Domperidone 40/30 mg, one capsule 30 minutes prior to breakfast for two weeks.

Other remarks:

1. Avoid skipping meals.

2. Avoid colored drinks such as coffee, tea, soda, juice. Take water only.

3. Avoid high carb intake, 1 cup of rice per meal should suffice. Lessen the intake of bread and biscuits.

4. After your last meal, there should be a 2-hour interval before you lie down.

5. Increase water intake and high fiber diet.

6. Avoid spicy meals.


Regarding follow up:

Follow up after two weeks.


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