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Breathing problems with diaphragm protrusion

Hello, I have the following problem: I have a diaphragmatic hernia. The following examinations were carried out: ultrasound, x-ray, ct, mrt and a lungoscopy. A tumour was ruled out. The diaphragm on the right is non-functional. The doctors think I have to live with this condition. My problem is that I have trouble breathing. With light exertion, e.g. staircase, 2nd floor, walking 200 metres, I am so out of breath that I need about 10 minutes to breathe normally again. I work independently in the field. I can hardly keep up with my work. I am 51 years old. Therapy: Breathing technique and hot roll. I have not yet seen any improvement. Is there anything else that can improve my situation?

The posts from this dummy user come from real users from the German-speaking community throughout the 15 year-long exchange on the forum.


  • Response 1:

    I also have a diaphragmatic hernia and it's very difficult to breathe. You have to pay special attention to what you eat, because if you eat too much at once, there's even more upward pressure on it. With me, the symptoms are only intermittent, my doctor said I have to live with it. But sometimes physiotherapy can really help. I had respiratory school in rehab, which wasn't bad either.

    When I have breathing problems, I don't know how else to help myself, and I smear everything with China oil. Flatulence medicines can also be very helpful - Lefax - Saab Simplex - anything with simeticon in it, including Espumisan. You can get everything over-the-counter at the pharmacy or drug store.

    Response 2:

    Good morning,

    The good news is that all available tests have obviously been carried out and no "malignant" cause has been found. This does not improve the breathing situation itself, but it takes away the worries related to the uncertainty and possible (serious health) fears for the future.

    At high performance, breathing is basically performed by the diaphragm (= muscle) on the one hand (abdominal breathing) and on the other hand by the muscles of the rib cage and the auxiliary breathing muscles (shoulder/neck etc.). As a rule, the contribution of the diaphragm to respiratory performance plays a subordinate role in quantitative terms, but it can become more important in the case of other dabilitating factors, in particular paralysis of the muscles of the chest, for example in the case of paraplegia or neurodegenerative diseases such as MS or ALS.

    Asthma and/or COPD (=diseases with constricted bronchial tubes where breathing out is the main problem) usually do not lead to a diaphragmatic elevation but, conversely, to an overinflation of the lungs and a flattened diaphragm. In addition, the diaphragm can only help with inhalation (=active contraction, no longer works during diaphragmatic paralysis); with exhalation (=slackening of the diaphragm), even a healthy diaphragm cannot contribute anything at all.

    From this point of view, asthma and diaphragmatic hypertension are two completely different things and both are probably so-called "incidental findings" in the course of various examinations. Depending on the severity of the asthma, the asthma is probably the main reason for the shortness of breath during exertion and not the diaphragmatic elevation itself. This means that asthma inhalation therapy should be of focus, ideally in the close company of a lung specialist and guided by peak flow measurements (traffic light system) that you have carried out yourself. This is actually all quite simple.

    Unilateral diaphragmatic protrusion is relatively common and does not lead to (serious) breathing difficulties on its own. The cause of the paralysis often remains unclear. Relative diaphragmatic protrusion (i.e. without paralysis) can also occur with obesity (especially of the abdomen), with gastrointestinal hyperinflation and with pregnancy.

    Shortness of breath is also a question of training condition, bodyweight (performance, restriction) as well as other potential limitations oxygen supply or CO2 exhalation (heart, blood, age etc.).

    Therefore my recommendations: 1) Forget about diaphragmatic elevation, 2.) Control asthma (inhalation and regular checks by a lung specialist), 3.) Rule out other causes (anaemia, chronic inflammation etc.) at the family doctor's, 4.) if necessary, urgently stop smoking and reduce weight, 5.) Endurance training (preferably cycling, light jogging if possible).

    The posts from this dummy user come from real users from the German-speaking community throughout the 15 year-long exchange on the forum.

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