Brief Answer:
Probably not related to your sinuses.

Detailed Answer:
Hi XXXXXXX
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.

Based on you query, my opinion is as follows:

1. Sinus issues would usually present with a cold. Headache would be severe and more as the day progresses. If it is the sinuses, steam inhalation along with antihistamines should reduce the symptoms.

2. Ears may or may not get affected with sinus inflammation or infection. The eustachian tube connects the nasal cavity with ear. When you blow and you feel, your ears pop, then it means the eustachian tube is clear. Possibly not sinus related. However, you can try steam inhalation (twice to thrice daily) along with antihistamines, whether it will relieve your symptoms.

3. As you are already on Gabapentin, its possibly not a neurological pain.

4. Regarding serotonin syndrome, if you recently started taking both Cymbalta and Trazadone in the past two weeks, then it would explain the headache, nausea and diarrhea. More details necessary regarding these medication. However, if serotonin syndrome were to stop, you have to stop one of the medication, which you need to discuss with your doctor as I am not sure, whether you are taking both for depression or other causes.

5. If you have recently started any medication, we need to look into it.

6. For diarrhea with groin pain, you can take antispasmodics to relieve pain. Immodium is an over the counter anti spasmodic that could help. Even though it OTC, its always better to discuss taking such medications with your primary doctor. Take plenty of fluids to avoid dehydration and do watch your diet, if anything in diet is causing more symptoms of nausea and diarrhea. You can try to change the diet and look into it.


7. You need to avoid further stress as you can get addicted back to alcohol. The stress, if building up, will need action to be taken. You need to relax, spend more time with family and friends. Try to adopt good eating habits (particularly protein - alcoholics are prone for malnutrition, your nutrition might be improving), do relaxation exercises, meditation and regular sleep. If still stressed, get help. Meet a psychologist to get counseling if needed.

Do get back with more details.

Hope it helps.
Any further queries, happy to help again.

Dr. Prakash HM

---

Brief Answer:
Possibly not serotonin syndrome

Detailed Answer:
Hi,
Thanks for asking again.

Trazadone since 3 months and Cymbalta since 6 weeks, should not be the cause of suspected serotonin syndrome since past two weeks.

There are no criterias satisfying Serotonin syndrome at present. High fever, muscular rigidity, excessive sweating, or agitation is not being seen.

More than the medications, I would think of alcohol induced stress leading to present scenario. You should try to relax.

No abnormalities on abdominal CT is good. Was any colonoscopy or stool examination done? Gastritis can cause diarrhea or stress could lead to gastritis, either way.

You need to be treated with proton pump inhibitors with domperidone to reduce GERD. This might help in diarrhea. As i told earlier, take more fluids, fiber rich diet and watch if any specific food is contributing to diarrhea.


Hope it helps.
Any further queries, happy to help again.

Dr. Prakash HM

---