Will gastritis cause shortness of breath?

Question

Hello doctor,

A couple of months ago, I began experiencing tightness in my chest, shortness of breath, and overall fatigue. I visited a walk-in clinic, where they performed an EKG, and everything appeared normal. They advised me to follow up with a physician. The nurse conducted a complete blood test and a chest X-ray, both of which also returned normal results. However, she still recommended that I see a cardiologist for my heart palpitations.

I consulted the cardiologist, who performed an ultrasound of my heart and placed a Holter monitor on me for a day. All the results were normal, yet I continued to experience these issues. I intermittently feel shortness of breath, chest tightness, and a heavy, dizzy sensation at the back of my head throughout the day. The heaviness is more pronounced after meals.

Because I also experienced some reflux, I saw a gastroenterologist, who confirmed that I have acid reflux and prescribed Omeprazole twice a day. To address the shortness of breath, I visited a pulmonologist, who diagnosed me with asthma after performing a pulmonary function test (PFT). He prescribed corticosteroids to be used twice daily and a short-acting beta-agonist for asthma attacks. I have been using the corticosteroids for four days, but I do not feel that my condition has improved.

The shortness of breath is intermittent and becomes particularly pronounced when I climb a small flight of stairs or even when I walk for a while. I researched the causes of my symptoms online and found information about serious conditions like pulmonary hypertension and pulmonary fibrosis, which have symptoms similar to what I am experiencing. I want to note that, to date, I have never had a proper asthma attack. Given that it has been four days without noticeable improvement from the corticosteroids, I am anxious about the possibility of having other serious issues like pulmonary hypertension or pulmonary fibrosis.

Are the symptoms I am experiencing typical for an asthma patient? Considering I have had a chest X-ray, a heart ultrasound, and wore a Holter monitor for a day, is it still possible that serious conditions could have gone undetected?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

My impression of your condition is that you have gastritis and reflux disease, which are causing acid to reflux into your lungs and lead to bronchoconstriction. This bronchoconstriction results in shortness of breath and an asthma-like pattern on the pulmonary function test (PFT). The likelihood of heart disease is low, as your age and symptoms are not very compatible with that diagnosis. Your ECG (electrocardiogram) is normal, and heart symptoms typically occur with exertion and are relieved with rest; all evaluations have returned negative results.

Regarding the possibilities of pulmonary hypertension and fibrosis, I do not support those diagnoses. These conditions are more commonly seen in females and older individuals. Importantly, your PFT and ECG are normal, which helps rule them out. I suggest you try the following:

Avoid fatty, oily, and spicy foods.
Go for a walk after eating instead of resting.
Have multiple small meals instead of heavy meals.
Maintain regular sleep habits and manage stress.
Consume plenty of green leafy vegetables and fruits.
Elevate your head with pillows while resting and sleeping.

I recommend trying Pantoprazole and Domperidone 40 mg three times a day for two weeks, along with a prokinetic to help propel the acid forward. If you still do not experience adequate relief, consider adding syrup Sucralfate and Oxetacaine, two teaspoons three times a day for a week. You can discontinue the inhaler and steroids.

I hope this advice is helpful. Please feel free to reach out if you have any questions.

Regards.