Feeling Unwell and Anxious About My Health
I'm a 24-year-old male, weighing 14 stone and standing at 5 feet 6 inches tall. I have a Caucasian background, don’t smoke, don’t drink alcohol, and I have mild asthma and sensitivity to house dust mites. I don't use recreational drugs. My current medication includes Lansoprazole at 45 mg, Escitalopram at 5 mg, and Prochlorperazine as needed. Since December 2024, I've been experiencing several troubling symptoms. It started with a sensation of pressure in the middle of my chest, difficulty breathing, and a constricted feeling in my throat. Concerned, I visited the emergency department where I underwent blood tests, clotting studies, and a chest X-ray—all of which came back normal. Subsequently, I had an upper gastrointestinal endoscopy that revealed a 2 cm hiatal hernia, which might explain both these symptoms and the ongoing IBS-like issues I’ve had, such as bloating and nausea. Consequently, my Lansoprazole dosage was increased from 15 mg to 45 mg. Around this time, my antidepressant was switched from 5 mg of Escitalopram to 50 mg of Sertraline after being on the former for approximately six months. However, by February, I began to feel increasingly fatigued and developed severe migraines. My doctor arranged for a head CT scan and a lumbar puncture because my mother had suffered from a ruptured aneurysm a few years back. Fortunately, those tests returned normal results, although my blood work indicated slightly elevated liver function—a condition that has persisted for years—as well as a lower-than-normal level of folic acid (3.3). A liver fibro scan showed no abnormalities. Fearing that Sertraline might be contributing to my issues, I gradually reduced my dosage over a two-week period and have been off of it entirely for about a month now. My doctor mentioned that this wasn’t the best course of action and we made the decision for me to return to 5 mg of Escitalopram, which I have preferred. I've been back on it for about four days. I’m concerned that I might have inadvertently triggered withdrawal symptoms? Additionally, I've been troubled by a tight feeling in my throat and frequent gagging. In January, I consulted with an ENT specialist who conducted a nasal endoscopy into my throat; he found it to be somewhat dry, with some saliva present, but no signs of allergic reactions or acid reflux. Unfortunately, this issue continues to bother me daily. Currently, I’m persistently weak, dealing with daily migraines and that constricted feeling in my throat, often gagging and experiencing dry heaving. I returned to the emergency room due to black stools, but they found my blood tests to be generally normal, attributing it to either my diet or possibly due to the Pepto-Bismol recommended for my hiatal hernia. The chest pain has mostly subsided, which suggests that the proton pump inhibitor may have mitigated that issue. I considered getting a full-body MRI, but I’m unsure if I could handle the procedure given the ongoing nausea. Any advice would be greatly appreciated as I’m feeling quite desperate. Thank you very much for your help!
Answers (1)
3/30/2025, 12:50:47 PM
OpenHealth AI
It sounds like you’re experiencing a range of distressing symptoms that are affecting your quality of life, and it’s understandable to feel anxious about your health in this situation. Let's break down your concerns and focus on actionable steps.
Main Points:
- You are experiencing ongoing symptoms including throat tightness, gagging, fatigue, and migraines, which can be distressing.
- You have had a comprehensive workup including tests that returned normal, which is reassuring, but your symptoms persist.
- Your medication adjustments and current health conditions may also play a role in how you feel.
Explanation:
Your history suggests a complex interplay between your physical symptoms and mental health. The sensations of pressure and the tight feeling in your throat can often be associated with stress and anxiety, especially following significant health concerns. The upper GI issues could be exacerbated by your hiatal hernia, and the elevated liver function and low folic acid may also contribute to your overall feeling of unwellness.
The sequence of changing medications, particularly involving antidepressants, can lead to withdrawal symptoms or discomfort. Symptoms like fatigue, mood changes, and headaches can occur as your body readjusts to changes in medication levels.
Next Steps:
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Medication Monitoring: Since you've recently returned to Escitalopram, give it some time (generally a few weeks) to see if your mental health improves along with your physical symptoms. However, remain vigilant for any side effects; if you feel worse, it may be worth discussing this with a healthcare professional sooner rather than later.
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Symptom Management:
- Hydration and Diet: Ensure you're drinking plenty of fluids and eating a balanced diet rich in vegetables and fruits to support your liver health and address any dietary issues related to IBS. Avoid heavy or trigger foods that may worsen nausea or bloating.
- Regular Meal Patterns: Eating smaller, more frequent meals can reduce pressure from your hiatal hernia and may help with nausea.
- Gag Reflex: Consider mild throat lozenges (if approved by your doctor) or over-the-counter options that soothe the throat while keeping it moist.
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Pain and Migraine Management:
- Maintain a journal to track migraine triggers and your overall symptoms; this can help identify patterns related to stress or diet.
- Consult with your healthcare provider about appropriate migraine management strategies, including possible medication adjustments.
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Stress and Anxiety Management:
- Explore relaxation techniques such as deep breathing, mindfulness, or gentle yoga, which may help reduce feelings of anxiety and improve throat tightness.
- If you’re comfortable, discussing these persistent symptoms with a mental health professional or a counselor may provide additional support.
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Follow-Up Care: Continue to keep in touch with your healthcare team. If symptoms persist or worsen, request more focused discussions regarding your symptoms, especially concerning psychosomatic links, gastrointestinal management, or potential referrals to specialists like a gastroenterologist or neurologist.
Reassurance:
It's understandable to feel overwhelmed given the complexity of your symptoms and the uncertainty surrounding them. You’re taking important steps by seeking help and managing your health actively. Please take care of yourself, and consider the outlined steps to help you navigate this challenging time. If you have further questions or need clarification, don't hesitate to ask.
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