Find out a most unlikely cause of difficulty breathing IN during or after exercise in the absence of chest pain in an otherwise healthy person.
Suppose you just had your heart checked and everything’s normal, but you have sudden-onset difficulty breathing IN during or right after exercise (or any other time of the day, for that matter), and there’s no chest pain.
What might this be?
You may want to pay a visit to an otolaryngologist (ear, nose and throat doctor), because a condition called laryngopharyngeal reflux can obstruct breathing, says Dr. Stacey Silvers, MD, of Madison ENT & Facial Plastic Surgery in NYC, who is board certified in otolaryngology.
“Sudden or gradual voice changes, choking symptoms, coughing and shortness of breath are usually symptoms of laryngopharyngeal reflux or LPR,” says Dr. Silvers.
This condition can be misdiagnosed as exercise-induced asthma, even though, as Dr. Silvers explains, difficulty inhaling is not a symptom of asthma. In asthma, the breathing difficulty pertains to exhaling.
This condition can be misdiagnosed as exercise-induced asthma, even though, as Dr. Silvers explains, difficulty inhaling is not a symptom of asthma. In asthma, the breathing difficulty pertains to exhaling.
“LPR happens when acid reflux gets up to the level of the larynx,” she continues.
“The result of this acid is swelling at the back of the vocal cords. This swelling keeps the vocal cords from coming together properly and leads to hoarseness.
“The swelling creates a structural blockage and can make is hard to take a deep breath.”
When LPR comes on, you may have only one of its symptoms, such as difficulty breathing in, which can be quite alarming if this occurs right as you’re catching your breath after wind sprints across a gymnasium.
If trouble breathing strikes while catching your breath after a burst of exercise, you won’t be very motivated to speak to check if your voice is hoarse; you’ll be too busy struggling to inhale.
By the time the episode (which may be very brief) is over, your voice may sound normal.
“The swelling can tickle the vocal cords and cause a dry cough,” continues Dr. Silvers.
“And this swelling can give you the sensation of a lump in the throat and occasionally difficulty with swallowing.”
Diagnosis of Laryngopharyngeal Reflux
“All of these mentioned symptoms do not have to be present to make a diagnosis of LPR.
“A physical exam by an otolaryngologist can confirm this diagnosis with an examination of the larynx.
“This is a common problem with people of all ages. Even young healthy people can develop LPR during stressful periods, eating a poor diet, even during exercise. The symptoms of LPR can be constant or come and go.”
If you experience trouble breathing during or after exercise, especially if there’s chest pain, consult with a physician to rule out a more dangerous cause.
LPR is benign (though if left untreated, it can lead to esophageal cancer).
Keep in mind that trouble breathing from a heart problem isn’t always accompanied by chest pain.
An NYC expert in ear, nose and throat care, Dr. Silvers has been named among America’s Top Physicians and Surgeons in facial plastic surgery and otolaryngology numerous times since 2003.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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