Can GERD cause chest pain and breathlessness at night?

Question

Hi doctor,

I am a 50-year-old woman who has had GERD for many years. But recently I have started experiencing tightness in my chest and occasional shortness of breath, especially at night and after meals. These symptoms are new and quite distressing, as they disrupt my sleep and daily activities. I am worried that this could be GERD affecting my respiratory system, possibly triggering asthma-like symptoms, or it could indicate something unrelated to GERD. What diagnostic tests, such as pulmonary function testing or imaging, would help identify the cause, and what treatment options would you suggest?

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

While it is true that the most common symptoms of GERD (gastroesophageal reflux disease) include indigestion, difficulty swallowing, regurgitation, and heartburn, the other symptoms of GERD are chest pain, cough, and hoarseness. Although most patients have mild diseases, esophageal mucosal damage (reflux esophagitis) develops in one-third and more serious complications develop in a few others.

So, your symptoms are most probably GERD complications. The pulmonary function test is not indicated in your condition. On the other hand, establishing a causal relationship between gastroesophageal reflux and extraesophageal symptoms (for example, asthma, hoarseness, cough, and sleep disturbance) is difficult. Gastroesophageal reflux disease is the sole of extraesophageal disorders but may also be a contributory factor. Although ambulatory pH testing can document the presence of increased esophageal reflux, it does not prove to be a causative connection, the current guideline recommends using a trial of proton pump inhibitors twice daily to be administered for two to three months.

The upper endoscopy is excellent for documenting the type and extent of tissue damage in gastroesophageal reflux, for detecting other gastroesophageal lesions that mimic GERD, and for detecting GERD complications. Barium esophagography can also be done unless you have severe difficulty swallowing. The medical treatment advisable is to treat esophagitis (if present) and prevent further complications. The initial therapy advised is Omeprazole 20 mg (milligrams) to be taken daily. I hope you find this helpful. I look forward to any questions or feedback you may have.

Thank you and take care.