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- Fri Aug 26, 2005 6:27 pm
I am a 49 year old woman with a hiatal hernia, GERD, allergic rhinitis, and fibromyalgia. Often when I awake in the morning, I go into a coughing episode, spitting up clear and watery mucous, clear acid, and sometimes the food from the night before in big chunks. I had an upper GI and that is when they found the hernia. I have been tested for allergies and was given bronchialdialators and they did not help. Sometimes it gets so bad that I cannot breath, like having an asthma attack. Once I have coughed or vomited up all the "plugs" of mucous and some of the acid, the spasms slow down and eventually stop. I have tried taking Prilosec before bed and seem to need to take a lot of things like Rolaids during the week. I don't have a runny or stuffed nose and sleep with my head elevated. It seems the attacks are much worse when I am anxious or over tired. Is this allergy related or stomach related or both?
I hope someone out there can help me as I don't want to undergo a lot of expensive tests for the wrong thing.
| Dr. Safaa Mahmoud
- Sun Jul 09, 2006 8:02 pm
The anatomical relation between the diaphragm and the Lowe Esophageal Sphincter LES prevents the gastric acids to come up into the esophagus (reflux).
When the upper part of the stomach prolapses through the diaphragm (where the esophagus pass into the abdomen (esophageal hiatus- opening) into the chest, the condition is known as hiatal hernia.
In this condition people will experience one or more of these symptoms, chest pain, pain in the throat, morning hoarseness, swallowing problems and GERD with or without heart burn.
The size of a hiatal hernia and the severity of the symptoms are not correlated. The presence of hitaus hernia aggravates the GERD condition.
Acid reflux causes severe pain and discomfort in the chest.
Others may experience a feeling like the food stuck in their throat or tightness in the throat, dry cough and shortness of breath.
The reflux and the regurgitated food particles causes congestion of the throat and irritation of the upper air ways as well, add to that the fact that you have allergic rhinitis , all these factors result in the secretions that are felt early in the morning.
Another important fact, is the high possibility of having concomitant (at same time) Asthma and GERD.
Prokinetic drug that strengthens the sphincter and improves the gastric emptying. When there is an acid reflux it is not enough to treat the symptoms with one drug instead the addition of Anti acids, Acid H2 blockers or proton pump inhibitors mat help to control the symptoms.
Certain foods are known to aggravate the condition, and you better avoid them. These include chocolate, beverages containing caffeine, fatty and fried foods, garlic and onions, spicy and tomato containing foods.
Surgery is considered only if lifestyle changes and medications did not improve the condition or if complications are present.
Keep on follow up with your doctor, update him with your symptoms, by complete history and physical examination, he can recommend the proper medical approach.