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Feeling Dizzy With Indigestion, Throat Problem. Had Pharyngitis And Tonsillitis. What To Do?

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Posted on Tue, 2 Apr 2013
Question: - Feel dizzy most of time. Like i took 2 3 circular rounds and head giving stimulus of pendulum.
While writing i am still feeling it. Its not that high that i can fall. When i am static then i feel it most, but not much while walking.

- Every morning after i wake up, feel my nasal area harsh.
- Had Pharyngitis for <=2 weeks immediately followed by tonsillitis. Both gone but little sign of painless tonsillitis(left more swollen than right) is there from 4-5 days and today i got a redness near left side of ulva. No pain.
(Ref: Images IMG_0000_0000.jpg, IMG_0000_0000.jpg ).

- Sometimes a sharp pain for a second in morning while i am about to wake up. 1.5inches top-right from belly. that pain doesn't appears even if i press that area with hands no matter how hard. Its so rare that maybe i don't feel it while sleeping or it doesn't occur everyday at all.

- Some times while sleeping i get sweat even in winters. Its also very rare. I cannot tell doctor when it happens or when it can happen. Its just rare / random. May be due to stress or overwork.

- Food particles come in stool. but stool is generally normal. Semi-solid paste like, brown. 5-6 months back i had bit of greyish poo. They are gone.

I don't want to ignore these things, my dizziness had made my working ability fall extremely bad. For rest of things i feel i am getting better in digestion, acidity doesn't appear etc. But Throat problems. dryness/hoarseness (just like at the very beginning of cough) near palate after sleep.

Please help.
doctor
Answered by Dr. Seikhoo Bishnoi (37 minutes later)
Hello,
Welcome to XXXXXXX

You have described your symptomatology in detailed manner. Before proceeding to your question, a brief about your clinical condition-

You have past history with repetitive episodes of pharyngitis. You have been on treatment of worm infections, family history of Panic Attacks in both parents. No known allergy except due to dust, vitals is more or less in normal range, all investigations are in normal range.
Presently you have complaints of not feeling well, dizziness, and heaviness in nose and throat in morning, problems of digestion, and occasional episodes of sweating in night. Dizziness is to such extent that it is hampering your work.

Now coming to answer part-

The symptomatology you have mentioned may be due to a number of reasons-

One thing we can think is Frontal Sinusitis (chronic). You have history of allergy to dust, repetitive pharyngitis. Presenting complaints of harsh nose and throat in morning, then dizziness. Due to infection of Frontal Sinus such type of symptoms are seen. I will advise you to go for X-Ray Frontal Sinus to rule out any evidence of chronic sinusitis.

Other thing is Non Specific Anxiety Disorder. You have family history of Panic Attacks, also history of panic attack in you also, episodes of sweating (although occasional), altered bowel habits, problem of indigestion, light pain in epigastric region, dizziness etc. Anxiety may cause such symptoms. In addition, you have problem of indigestion, stools are semi solid paste like and pain abdomen etc. Therefore, this is pointing to Irritable Bowel Syndrome, as your all investigations are normal. Anxiety and Irritable Bowel Syndrome is most likely possibility. For management of this dizziness you have to visit a good Psychiatrist.
-Treatment of anxiety with medicines like SSRI (Sertaline, Fluoxetine, Paroxetine etc.) will not only improve dizziness but will also cover altered bowel habits. If problem of indigestion and acidity persist then other medicines like Libratax can be taken.
-Home based exercises, XXXXXXX breathing exercises, relaxation techniques, yoga will also help
- For symptomatic treatment of Dizziness, you can take medicines like Betahistine, Cinnarizine etc. They will improve the symptoms for some time until other medicines work.


In reports you attached-
USG is normal
Throat is showing mild congestion and slight enlargement of tonsils. So I will advise you to continue antibiotics for 5 days at least. Warm saline gargles or gargles with chlorhexidine will also help in early improvement.

Therefore, everything is normal.
Hope I solved your query, I will be happy to answer you again if you have some more questions.

Thanks
Dr. Seikhoo Bishnoi



Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Seikhoo Bishnoi (1 hour later)
Hi,


Thank you for the followup.

As per your suggestion regarding SSRIs, i had been to the doctor for panic attack on May 2012. He prescribed me (petril) Clonazepam tablet and later Sertraline. However i was fine and stopped the medicines and then never taken, they were making my sleep hectic. I started Shankhrushpi-Brahmi syrup and now am fine. Don't have such troubles now.

But In February 2013, sore throat was epidemic here, few of my family members were infected too including my mother and she was prescribed Levofloxacin. However i mostly avoid antibiotics because i have had many early due to poor immunity and i fear resistance by organisms to particular antibiotic. If you suggest then i will take 5 day course (with the reference mentioned hereby) Or if possible any alternatives. Right now i don't feel any pain or cough in oral region.

I was not feeling that much dizzy before or during sore throat, when my throat got relived then dizziness started.

IBS, it may be due to some food intolerance i might be neglecting as reason but now i rarely get acidity, gas and pain. But the sharp pain in empty stomach was doubting me for ulcer or parasite. But from long time i sleep tight with timing. Except dizziness i feel well by rest of body.

One more important thing i forgot to mention is:
I had drunk open tank water for a month due to misinformation from office boys regarding TAP of bathing water and drinking water.

January 2011, drunk open tank water
Feb 2011, had intense pain in stomach with heavy gas. Was cured in emergency in hospital.
afterwords i was getting this right-side pain in stomach which was relieved last year but looks like it exists. For the same i was tested by USG, stool test in 2012. All were -ve. But i was fearful of any rare parasitic infection. Tried some ayurvedic medicines and diets like Triphala which helped my abdomen.



If you feel that i need medicines for my current painless throat which cannot recover by own or lead to chronic conditions then please prescribe me the medicines for same and for primary therapeutic care of frontal sinusitis. Like if i can start Levofloxacin/Cipro course? thereafter i can visit hospital further for Frontal Sinusitis diagnosis.


I thank you for all advices you gave :).


Regards,
Bindesh XXXXXXX XXXXXXX

doctor
Answered by Dr. Seikhoo Bishnoi (14 minutes later)
Hello again

In Feb 2013 epidemic of Flu was there in North India. After the infective phase, a lot of people complained of epigastric distress apart from ENT problem. Although use of antibiotics is not for viral infection, but doctors give antibiotics in viral infection just to counteract the secondary bacterial infection. You had episodes of pharyngitis and presently we are suspecting sinusitis may be a reason for your dizziness and rash nose in morning so I am in favor of antibiotic course for at least 5 days. If you do not want to take antibiotics then get x XXXXXXX done to rule out chronic sinusitis. Steam inhalation daily for 3-4 times a day will help to clear the secretions from sinuses. Antibiotics like Amoxicillin or Ampicillin+Cloxacillin combination are best in such situations. However, discuss with your physician before starting any antibiotic.

You were on Sertaline and Clonazepam and then controlled anxiety by self-control. This is good but as you have mentioned sweating attacks along with other symptoms, so a Psychiatric evaluation is needed if symptoms reoccur. As I mentioned in my previous answer, home based relaxation techniques will help you a lot.

Irritable bowel syndrome does not occur with infected water. I am just suspecting it in you, but as you are saying that there are no major symptoms of digestion at present, so no need to worry about IBS.

Hope I cleared your doubt .

Thanks
Dr. Seikhoo Bishnoi

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Seikhoo Bishnoi (19 minutes later)
Hi,


I used to do Yoga in 2009 but due to office i stopped because of timing. I have started doing again. I surely will follow home remedies like gargling hot water etc from now at-least to not worsen the situation of ENT infections. Will continue to local hospital.

I thank you for taking look on my health condition and providing necessary feedback and ruling out my doubts.


regards,
Bindesh XXXXXXX XXXXXXX
doctor
Answered by Dr. Seikhoo Bishnoi (2 minutes later)

Thank you so much.
Wish you a good health.
Please review the answer.

Thanks
Dr. Seikhoo Bishnoi
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

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Feeling Dizzy With Indigestion, Throat Problem. Had Pharyngitis And Tonsillitis. What To Do?

Hello,
Welcome to XXXXXXX

You have described your symptomatology in detailed manner. Before proceeding to your question, a brief about your clinical condition-

You have past history with repetitive episodes of pharyngitis. You have been on treatment of worm infections, family history of Panic Attacks in both parents. No known allergy except due to dust, vitals is more or less in normal range, all investigations are in normal range.
Presently you have complaints of not feeling well, dizziness, and heaviness in nose and throat in morning, problems of digestion, and occasional episodes of sweating in night. Dizziness is to such extent that it is hampering your work.

Now coming to answer part-

The symptomatology you have mentioned may be due to a number of reasons-

One thing we can think is Frontal Sinusitis (chronic). You have history of allergy to dust, repetitive pharyngitis. Presenting complaints of harsh nose and throat in morning, then dizziness. Due to infection of Frontal Sinus such type of symptoms are seen. I will advise you to go for X-Ray Frontal Sinus to rule out any evidence of chronic sinusitis.

Other thing is Non Specific Anxiety Disorder. You have family history of Panic Attacks, also history of panic attack in you also, episodes of sweating (although occasional), altered bowel habits, problem of indigestion, light pain in epigastric region, dizziness etc. Anxiety may cause such symptoms. In addition, you have problem of indigestion, stools are semi solid paste like and pain abdomen etc. Therefore, this is pointing to Irritable Bowel Syndrome, as your all investigations are normal. Anxiety and Irritable Bowel Syndrome is most likely possibility. For management of this dizziness you have to visit a good Psychiatrist.
-Treatment of anxiety with medicines like SSRI (Sertaline, Fluoxetine, Paroxetine etc.) will not only improve dizziness but will also cover altered bowel habits. If problem of indigestion and acidity persist then other medicines like Libratax can be taken.
-Home based exercises, XXXXXXX breathing exercises, relaxation techniques, yoga will also help
- For symptomatic treatment of Dizziness, you can take medicines like Betahistine, Cinnarizine etc. They will improve the symptoms for some time until other medicines work.


In reports you attached-
USG is normal
Throat is showing mild congestion and slight enlargement of tonsils. So I will advise you to continue antibiotics for 5 days at least. Warm saline gargles or gargles with chlorhexidine will also help in early improvement.

Therefore, everything is normal.
Hope I solved your query, I will be happy to answer you again if you have some more questions.

Thanks
Dr. Seikhoo Bishnoi