Hiatal Hernia and Asthma

Hello,  I am new here.  I came across this site when doing research on my symptoms. (sorry this is long!)

Little background, in 2006 i had a severe asthmatic cough for 4-5 months.  I finally went to my GP.  (I was diagnosed with asthma when i was a baby).   He put me on predinsone, did a bunch of tests and then sent me to a pulminary doctor for further testing since my x-ray came back that i had COPD, and at 25 with no history of smoking, that result was surprising.  The pulmonary doc took one look at me (quite mean) and said i dont have COPD, my breathing tests came back normal (predisone cleared me up) and said that i have acid reflux.  Prior to 2006 i have been on prednisone many times but i cant recall if it was ever this severe.

This past October, the same thing started happening, severe asthmatic cough 24 hours a day (from October 4th to the middle of Feb), every time i ate it got so much worse.   Instead of going to a pulminary doctor, i went straight to my gastro, who scheduled me for an endoscopy after hearing my symptoms.  Symptoms include burping after ingesting anything, including water; shortness of breath; nausea after certain foods; bloating after every meal, small or large; sore throat; and asthamtic symptoms, I could barely have a conversation with anyone or walk fast, thats how bad my asthma symptoms were. He also checked my lungs, didnt hear any phneumonia. He put me on GERD meds, which i took for a month and they did nothing except give me lower digestive problems. He recommended i go to a pulmonary doctor, but i didnt want to go to the same guy i went to previously so i found a new one who is such a great doctor.  He also didnt hear pneumonia or bronchitis.  He gave me a in-office nebulizer treatment, which helped and also put me on a controller inhaler.  He didnt want me going for the endoscopy without my lungs under control. My asthma symptoms declined enough for the endoscopy.

Endoscopy results came back with Hiatal hernia, which he described as being in my chest and Acid Reflux/Esopogitis, because there was major inflamation in my esophagus.  So in his opinion, he said that the hernia/reflux was triggering my asthma.  Because i hated the side effects of the GERD meds, i decided to make all the diet and lifestyle changes i could, including illiminating certain foods, beverages; trying not to overindulge; not eating at least 2-3 hours prior to bed time; and sleeping on an incline.  I seemed to be doing a little better but then my asthma acted up again the end of December and i was having the same severe symptoms again.  My pulmonary doc put me back on the controller inhaler and nebulizer treatments 2x a day.  I also chose to try the GERD meds again mid January (against every bone in my body), but again all they did was give me lower digestive problems, so i tried for a month straight with no help.  It wasnt until i went back on prednisone in February that my asthma cleared up.  I spoke to my gastro doc again, and he referred me to a surgeon that preforms laproscopic hiatal hernia surgery since meds arent working and my asthma is so bad.

so heres where im totally stuck and basically back to square one.

I went to the surgeon and he looked at my endoscopy results and basically thought i needed the surgery.  He also thought that i may have been misdiagnosed when i was an infant as having asthma when i probably had reflux.  (i most def have asthma though, i have allergic triggers, laughing and working out gives me reactions as well) He sent me for a barium esophogram and mamnomotry (spelling).  Both these tests came back normal, as in no hernia and no reflux (????) So now he is sending me for a PH test (24 hour test, they stick a tube up your nose and into your stomach and monitor for 24 hours) to determine if i actually have reflux.  he also said that if this tests comes back saying no reflux, i may have a food intolerance, which may be the cause of my esophogitis.  (I have been tested for food allergies and i dont have a single one.)  BUT, i still burp up everything i consume.  I can drink water first thing in the morning and burp up that.  I have noticed that i will get nauseas after eating certain high fat content food, such as guacamole - i can eat a ridicuolous amount in one sitting, fried foods (im not talking fast food, as i havent had fast food since i saw supersize me, 2004/5 maybe), Chicken or tuna salad- i assume its from the mayo; or high sugar content like candy.  I also can not eat chinese/thai/vietnemese foods as these foods actually make me so nauseaus that i will puke. 

I havent searched this site much yet, being that i just signed up.  But has anyone had these types of symptoms that mabye can shed light on reasons why i am having all these symptoms?

I am willing to try anything (except meds).  The surgeon suggested i keep a food diary, but like i mentioned, i can drink water and react. so i would be writing everything down hehe. But i might start doing that anyway, incase the PH test comes back with no reflux and i have to see a nutritionist.

My gastro also suggested i take Activated Charcoal for gas and bloating.  i've been doing that and sometimes it helps and sometimes it doesnt. Anyone out there take this stuff?

thanks for reading my post :)

 

PS: Forgot to say, a lot of people who have asthma also get GERD, and I do wonder why. Is it the asthma medication, or have we wheezed and squeezed our rib cages so much we are more prone to hernia etc?

I have shortness of breath, PVC's, Reflux, Heartburn and so on - and they've only found a sliding hernia. It hides himself - so one time it is visible and the other time it is gone. Thats why they name it "sliding hernia". In my opinion everything is due to this f... hiatal hernia. I hat nothing befor - and since I've got it I have a lot symptoms. More than you have!!! I am looking for surgery now

Dear Hasty820,

Welcome to Healing Well! I can definitely relate to your post. I also have asthma and had it as a child. Of course some of my asthma problems are caused by allergy, and I continue to have allergic symptoms during peak pollen season.

That said, I suffered with severe asthma (and was hospitalized with GERD-induced asthma) for at least four years before I finally had the courage to have the hernia/Nissen fundoplication surgery. I had a small hiatal hernia and very mild GERD, but my asthma/allergy doc and family doc were both convinced that the reflux was creating havoc with my lung health.

I was on prednosone periodically to no avail, and high doses of inhaled steroids. That amount of steroids created problems with my skin...it bruises extremely easily and is so thin that it tears. It is like the skin of a 90 year old. That effect will remain with me forever.

I wish my GI doc had been more positive on the surgical option earlier. He was the one who always stood in the way of moving forward with that option. I had no Barretts or esophagitis, as I had been on Proton Pump Inhibitors for about 15 years, and they provided protection.

As I said, my family doctor kept pushing and pushing for the surgery, and finally after at least four long, very unhealthy years, the GI doc suggested that I might visit the surgeon to just discuss the option. Three weeks later I had the surgery.

It took me two and a half months to clear up my lungs. They were so sick they were full of infection as well. It was rough, as I coughed severely throughout the recovery, which made the incisions more painful. Thankfully, however, the repairs held, and my wrap is intact.

While I can still have some asthma issues due to allergy, I am 100% better now. It doesn't take very much reflux to get the lungs going. My asthma doc says that GI docs are focused on the amount of reflux it takes to damage the GI tract, and have no idea how little it takes to inflame the lungs.

On the topic of food...allergy and intolerance are two different things. You can be intolerant to a food without being allergic to it. I think a journal of the foods you eat and your reaction would be a really worthwhile endeavor. Alcie, a member here, has found food intolerance to be a big trigger for her problems. Hopefully, she will weigh in on this discussion!

Best wishes! I hope you find an answer soon, and you get your lungs straightened around. Believe me, I know just what you're going through.

Take care,
Denise

Joan, that sounds like the 24 hr pH wire test.