Expert: Marc Rubin, RPh Asthma Educator - 3/27/2008

Question
Im 30 and I have in the past few months been experiences what feels like a breathing restriction on the left side of my chest only and feel like contstantly yawning to get enough air in that lung.  Just had chest xrays and they came back normal and also had EKG while back to rule out heart problem and that was normal.  My question is if I do have asthma, can it only affect my left lung and airways on that side?  No one in my family has asthma, thus I dont think that is what it is, but who knows.  I suffer from Gerd for years now and wonder if that has something to do with it as I know it can damage the esophagus.  My mom had to have her esophagus stretched because she started choking on food.  But, I would imagine if it was the problem, the damage would shown up on xray, and that I would also choke on food before having difficulty breathing.  I do on rare occasion have difficulty swallowing food but the breathing problem is everyday.  I just dont know what I should do.  I dont know how I could rule out asthma or not or if I should have more tests done.  Do you have any suggestions?  My blood pressure is a tiny high and I could lose a few pounds.  Im thinking I will lose some weight and lower blood pressure and see how I feel then.

Thanks
James

Answer
Hi James,

(Sorry for the delay in answer: I've been on vacation)

Asthma does not affect one lobe of the lung, it affects the entire lung. What may be occurring is bronchospasm due to the GERD. When the acid refluxes up into the esophagus, it creates an inflammation on the lining. The nerve that picks up the signal is the vagus nerve. The vagus nerve runs from the brain down through the throat and airways, to the heart and on to the intestines. When the vagus nerve gets stimulated at the esophagus level, it can trigger muscle spasms in the lungs, leading to symptoms not unlike what you have taking place.

You may want to have a pulmonologist perform a spirometric examination, but before going forward on that, I'd fully address having the GERD resolved. This would be done both through medication, as well as lifestyle changes: no caffeine, no chocolate, no smoking. In addition, if you are overweight, cutting the weight will also reduce the GERD. Obviously, all these things are not going to occur overnight, but must be part of a plan of action. Eliminating the chocolates and caffeine will start showing a positive effect in just a few weeks. The weight loss and smoking cessation (if you smoke), would be a long-term concerted effort. On the weight loss: diet AND EXERCISE are the proper way to go, and make your goal 1.5 to 2 pounds per week, no more. This will also help you with your blood pressure.

If after a couple of weeks of beginning lifestyle changes, you show no improvement, see a pulmonologist for a complete evaluation.

It is also important to inform your physician about your mother's condition.

Let me know how you are progressing.

Good luck!

Marc