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What Causes Severe Productive Cough And Shortness Of Breath Post A Hernia Surgery?

Posted on Tue, 15 Mar 2016

Question: I was diagnosed with excessive reflux into my throat and a hiatal hernia from a barium swallow test and upper GI scope. I had the hernia surgery in December; now I'm coughing and have extremely thick mucus from my throat - worse than before the surgery. I'm also short of breath - all of the symptoms the surgeon thought was a result of the excessive GERD. The mucus is worse when I eat, especially at night. My surgeon wants to send me to pulmonologist but next appointment is 2 months! I'm trying to get in sooner. I also have had sinus surgery 20 years ago and have chronic sinusitis, but this mucus is NOT the same as that. I take allergy shots for dust and have for years.

Answered by Dr. Drkaushal85 (38 minutes later)

Brief Answer:
Get done PFT (Pulmonary Function Test) to rule out bronchitis.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Yes, uncontrolled GERD (gastroesophageal reflux disease) can cause breathing difficulty.
GERD actually causes micro aspiration in lungs and this can cause inflammation in lungs.
This is known as bronchitis which causes breathing difficulty, mucus production and coughing.
So get done PFT (Pulmonary Function Test) for the diagnosis of bronchitis.
We should first treat GERD to control the bronchitis. Along with drugs, you need to follow these lifestyle modifications for GERD control.
1. Avoid stress and tension.
2.. Avoid hot and spicy food. Avoid junk food.
3. Avoid large meals, instead take frequent small meals.
4. Go for walk after meals.
5. Keep 2 - 3 pillows under head in the bed to prevent reflux.
6. Quit smoking and alcohol if you have these habits.
Once your GERD is under control, your breathlessness and mucus will also control.
If PFT is suggestive of obstructive airway pathology then you will need inhaled bronchodilators, inhaled corticosteroid, mucolytic and expectorant drugs.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (26 minutes later)

I have had bronchitis in the past and this doesn't feel the same. The mucus seems to come from the throat area only - voice box area. It's clear but very thick. And 99% of the time the mucus only occurs after I eat. The coughing other times is a hard dry cough but from the throat only - not deep in the lungs.

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
Are you following lifestyle modifications for GERD?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Your mucus production is associated with eating only. This is mostly seen with reflux disease.
So possibility of uncontrolled reflux is more.
Please let me know
1. Are you following all the lifestyle modifications to control GERD?
2. Do you have allergies?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (4 minutes later)

1. I had hiatal hernia surgery in December for the control of the GERD. The only improvement noted is my breath seems to be better - not as bad of a smell
2. I have dust allergies and chronic sinusitus. I take Singulair and allergy shots. i was taking Zyrtec but my the thick mucus was even worse when i took that medicine.

Since the surgery - I only have had soups, etc. Nothing spicy, no meat, no alcohol and the symptoms are only getting worse.

Answered by Dr. Drkaushal85 (18 minutes later)

Brief Answer:
Have you ever tried intranasal spray containing steroid?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
You are having two risk factors for bronchitis.
1. GERD
2. Allergy and sinusitis.
I still feel GERD is the biggest contributing factor your symptoms. Along with GERD, allergies and sinusitis give additive effect to your symptoms.
So we should definitely control sinusitis to prevent post nasal drip associated bronchitis.
Please let me know
1. Have you ever tried intranasal spray containing steroid?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (4 minutes later)

Many actually over the years. I'm not currently one. I had to stop because I was diagnosed with the beginning stages of glaucoma and I'm 45.

Should the GERD not have stopped though since I've had the surgery? I was under the impression that once I had the surgery, the GERD would be contained and no longer be an issue?

I do have another question - have you ever heard of Vocal Cord Dysfunction? I found it today while researching and seem to have a lot of the same symptoms: chronic cough, chronic throat clearing, shortness of breath (breathing in, not breathing out)

One more thing - I joke that I have the "Darth Vader" syndrome. It feels like someone is squeezing the sides of my throat. It was worse before the surgery but still present.

Answered by Dr. Drkaushal85 (18 minutes later)

Brief Answer:
No, surgery is not 100 % curative all the time.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
No surgery is not 100 % curative all the time.
Recurrence is common in hiatus hernia surgery. Along with surgery, you need to get done lifestyle modifications.
Yes, vocal cord dysfunction can be the cause.
I was about to ask you about this.
Please let me know
1. Do you have hoarseness of voice?
2. What is your profession?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (3 minutes later)

Hoarseness not all the time but by the end of the day it hurts / sore

I work in an office as a supervisor and I have 2 teenage children (I'm definitely NOT a singer - HA!)

I do take Cymbalta 60 mg for anxiety and treatment of fibromyalgia

I've had issues with Candida in the past.

Also, I meant to tell you that I do follow a Paleo - low carb diet about 85% of the time. I eat no artificial sugar and try to limit all sugar intake. However, since I've had my surgery, I've eaten lots of carbs - mashed potatoes, grits, etc.

Answered by Dr. Drkaushal85 (10 minutes later)

Brief Answer:
You should get done endoscopic examination of vocal cords.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
To rule out vocal cord dysfunction, you need to get done endoscopic examination of vocal cords.
You never told me about anxiety.
Uncontrolled anxiety can also cause worsening of GERD and worsening of symptoms.
So please let me know
1. Is your anxiety under control?
2. Since how many years, you are having anxiety issues?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (10 minutes later)

I had an upper GI done before my surgery - is that the endoscope that you are referring to? Or the one that the Dr does in office where the tube is down your nose into your throat?

yes - the anxiety is well controlled. I do have a stressful life but the anxiety is pretty good I think compared to what it was before I was on cymbalta.

Answered by Dr. Drkaushal85 (6 minutes later)

Brief Answer:
No this is not same endoscope.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
It's good that your anxiety is under control.
No, the endoscopy you are talking is different than what I am talking.
I am talking about laryngoscopy which is performed by ENT doctor to visualize vocal cords.
Do you have voice fatigue?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (7 minutes later)

Yes I sound "froggy" by the end of the day. Not really hoarse I don't think. I blame it on the dry cough that I have all day. I don't have problems at night waking up coughing, etc. The really bad time of coughing is when I eat - or if I laugh really hard

I've never been a really "in shape" person but had started an exercise program with my daughter before all of this started. Now I can't do anything hardly - even walking the stairs at our house is exhausting

Answered by Dr. Drkaushal85 (4 minutes later)

Brief Answer:
What kind of exercise program?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
You are now confusing me.
Please reply me
1. What kind of exercise program you are talking about?
2. Is it physical exercise or voice exercise?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

So sorry - no physical exercise not voice - just riding bikes, etc. . I just said that because now I can't because of the shortness of breath

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
Are you engaged with shouting or loud voices in office or at home?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
So to rule out vocal cord dysfunction, I must know
1. Do you have any accident in near past? I am asking this because trauma can injury nerve supplying vocal cords

2. Do you engage in shouting or loud voices in office or at home?
. Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar