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Labored breathing and nasal congestion

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Since moving to rural Thailand I have developed a bit of an occassional breathing issue.; whereas sometimes it feels like my throat is constricting (not severely though) and for a short period my breathing is more labored. It feels like there's air rushing up my throat and I can't swallow it back down for a couple seconds, and sometimes I get slightly lighthearted. It seems to be present if I haven't eaten enough solid foods, if I'm out socially, or if I'm around smokers. I have also been battling persistent nasal congestion. At times I also notice it when I go to certain public places, but it rarely happens when I'm at home by myself. I have cut back on my caffeine intake and it seems to be better. Thus, I don't know if it's due to social anxiety, an acid indigestion issue, or breathing in allergens and dirt where I'm living. My apartment is near a busy highway, so I imagine I'm breathing in some pollutants here. Also, I don't smoke, I drink alcohol maybe once a week and have 1-2 beers. What do you think the problem is? What can I do to make myself better?
Thanks! :-)

Category: Family Physician-GP

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Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.


Thank you for choosing DoctorSpring.

I have sought out team Pulmonologist's opinion on your case. Meanhwhile please let me know the following details :

1. Do you have similar symptoms with exercise ?
2. Do you have / feel rapid heart beat ?
3. Ever had breathlessness in night ?
4. For how may months you are having this symptoms ?
5. Is there any cough / noisy breathing ?
6. Do you get stressed up easily ? Would you say you have social anxiety ? - Is do mild / moderate / sever ?

you can reply as a followup
Thank you

Patient replied :

Thanks for the reply. When I exercise via walking for 45-1 hour I usually don't feel the symptoms. However, the last time I did weight lifting I felt a bit short of breath for ten minutes afterwards (but it was the first time in months I had weight lifted). Sometimes, yes I do feel a rapid heart beat, which is moderately rapid, but not extremely rapid. I haven't had any breathlessness in the night, I usually sleep well. I have had the symptoms for a couple months now. I rarely cough or breathe noisily. I do have some social anxiety, but it's strange since I enjoy meeting people, but still feel stress. Lately I've had stress since I'm underemployed, low on money and looking for a new job, so maybe that's contributing. My social anxiety around new people is at worst moderate. Thanks again, and please let me know your thoughts.


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.


Thank you for the additional details.

The symptoms you have mentioned are not suggestive of a respiratory cause per se. That is why I have requested more information. This short period of laboured breathing and throat constriction is possibly a part of a mild anxiety attack.

Another less likely but possible explanation is an allergic bronchoconstriction.

Either way there is nothing much to worry. Both are self limiting conditions. Once the temporary trouble and personal issues you are resolving these symptoms should resolve. You can take an anti allergy medication like Allegra once a day to see whether it helps in resolving the symptoms.

Do take active measures to stay calm and relaxed. Hobbies, yoga, exercise whatever works for you. Anti anxiety medications can be considered if the symptoms persists.

Hope this helps
Feel free to ask followups
Thank you

Patient replied :

Hi, thanks for the response. Usually the throat constriction is more noticeable if I am drinking beer and speaking to others. Does beer usually cause problems in terms of aggravating allergic bronchoconstriction? Also, what can be done about the persistent nasal congestion and heartburn/stomach discomfort? When I am out in a social setting and feel the throat constricition/trouble swallowing and the lightheadedness, what can I do to treat it? I exercise 45 minutes to an hour a day, so I am staying active, but I am unsure why my anti-anxiety is flaring up. Are there any over-the-counter medicines I can take for the bronchoconstricion and anxiety problems? Thanks! :-)

Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Beer theoretically can cause allergic reaction , but is unlikely in your case. The symptoms are not suggestive.
The GERD/ heartburn could be treated with OTC anti ulcer medication like Prilosec once daily just before sleep (NOT WITH FOOD) once a day for 14 days. This should take care of the stomach burn. Also do give anti allergic medication a trial for 3-4 days. Anxiety if persistent will require prescription medication. But I think it can be managed without it. Hopefully this is a passing phase.

Hope this helps
Thank you

Patient replied :

Hi, thanks! :-) I will get prilosec to combat my heartburn issues. To fix the nasal constriction problem, should I use Allegra, or would something like Singulair medicine work better? I believe this is a passing phase, the area I live in has a lot of dust, dirt, and pollutants in the air, so I think it's bothering my respiratory system. But, thanks again!

Expert:  Dr. Deepu Sebin Sebastian replied 1 Day.


Allegra would be better for the allergy symptoms. Again there could be an allergy component to the respiratory symptoms and allegra could take care of this also.

Hope this helps
Feel free to ask followups
Thank you

Dr. Deepu Sebin Sebastian
Category: Select Speciality
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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