27yr old asthmatic male c/o breathlessness and chest tightness after meals. *Chief Complaints* Breathlessness and tightness of chest *History* 27yr old asthmatic male c/o breathlessness and chest tightness after meals. The symptoms are not relieved with medications, seem to improve with time and aggravated after meals. The symptoms affect his day-to-day activities. The patient completed triple therapy 5 months back after he was diagnosed with GERD due to H. Pylori infection. He had breathlessness after the triple therapy until 1 month back. It subsided with formoterol and budesonide inhaler. Currently the patient is on 1. formoterol and budesonide inhaler 2. salbutamol and ipratropium bromide inhaler 3. T. Montek LC *Investigations* Endoscopy done 5 months ago- diagnosed with H. Pylori infection and triple therapy was started