What Causes Tightness In Upper Abdomen Along With Difficulty Breathing?

Posted on Sat, 27 Jun 2015

Question: I have a feeling of real tightness across my abdomen below my ribs / in my diaphragm. It is hard to get a full breath unless I yawn. Almost like asthma, but the breathlessness is not centered in my lungs, it is below. My belly feels turgid, but I am not bloated with gas. I have normal bowel movements / appetite / urination, Symptoms started with a difficult night on Monday, eased Tuesday morning and Tuesday night was not so bad. Wednesday night was bad, and on Thursday I actually had real discomfort for much of the day, the first time I have had this during the day. Thursday night was not bad and Friday during they day was pretty good; I thought I was over this episode but starting at 9 pm tonight (Friday) and through to now I have deteriorated again. It is not as bad as it has been, but I no longer think I am getting over it and want to know what this could be. The sense of turgid diaphram / band across stomach just under my rib-cage is probably the worst it has been.
I have no sense of pain in heart / chest; a little sense of 'stitch' but I think this is because I am struggling to stretch my ribs to take a deep breath.

Answered by Dr. Sandip Kabra (2 hours later)

Brief Answer:
Seems to be acute gastritis.

Detailed Answer:
Hi,
Welcome to health care magic,

I have read your query and understand the concern.

The feeling of tightness over upper abdomen or below ribs,diaphragm seems to be due to acute gastritis where one might have normal bowel movement and appetite.

The causes of gastritis could be helicobactor pylori infection,oily and spicy diet,or drug induced.

Here, I would like to know some more information
i ) is there any relation of your feeling tightness with meal?
ii) are you taking any medications?
iii) what's your routine diet?

Although,you can go for routine blood count,ESR,urinalysis with ultrasound abdomen with upper GI endoscopy to rule out other gastric pathology or to confirm gastric inflammation.

You may require h2 blockers (like ranitidine) or proton pump inhibitors (like pantoprazole,rabeprazole) with cytoprotective drugs like sucralfate,misoprostol etc.

You should consult general surgeon or gastroenterologist who may take complete medical history and thoroughly clinical examination with relevant investigations to diagnose correctly and can prescribe you above treatment.

Hope this will help you and feel free to ask me further.

Regards,
Dr.sandipkabra

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Sandip Kabra (9 hours later)

I have none of the other symptins of gastritis - no stomach pain etc. I have had a peptic ulcer in the past and hepatitis A. None of my current symptoms match what I felt with those conditions. However, I have been having mild headaches and occasional real migraines on waking often enough for that to become a concern. I also have sleep apnea and cannot sleep on my back without choking. I thought the headaches were related to oxygen deprivation caused by apnea but now wonder if the shortness of breath is linked. I also have more frequently felt my feet were puffy on waking but attributed this to lack of exercise and sitting at a desk all day. Again, I am beginning to think all these symptoms are linked
I am currently taking a diuretic as I was feeling bloated. My doctor told me I was pre-diabetic and the diuretic along with losing weight could help me avoid getting diabetes. I have not been able to loose weight and am currently 260 lbs and should be less than 200 lbs given my height, build and age

Answered by Dr. Sandip Kabra (11 hours later)

Brief Answer:
Needs further evaluation.

Detailed Answer:
Hi,
Thanks for the follow-up.

It is good that you do not have any other symptoms of gastritis but still when you have feeling of tightness in upper abdomen with also history of peptic ulcer,hepatitis A in the past,it must be evaluated further to diagnose correctly.

As I said earlier,you should see gastro-physician who can take complete medical history and order relevant investigations (complete hemogram,liver function tests,urinalysis,abdominal ultrasound and upper GI endoscopy) and start the treatment.

Your shortness of breath and sleep apnea might be linked but we need to rule out gastro-intestinal factors first.

For your occasional migraine,you can take symptomatic treatment if it is troublesome.

You can continue with diuretics as advised by your doctor considering your puffiness over feet on waking.

Try to reduce your weight by both diet (reducing fatty diet and carbohydrates) and exercises (at least half an hour daily) which will also help to improve your glucose intolerance or your pre-diabetic status.

I would suggest you to see gastro physician as stated earlier to rule out the causes rather than just thinking on your own.Your doctor will know all the factors better.

If still any clarification then feel free to ask me.

Regards,

Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Yogesh D