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Hypertension And Oral Allergy. Taking Nebstar And Allegra. Painful Swelling Under The Jaw. Due To Medication?

Posted on Mon, 16 Jul 2012

Question: Dear Dr.

few days back i went to the family physician he checked my blood pressure and foung elevated so he prescribed me nebstar 5 i also had oral allergy he gave me allegra 120. As i took these medicines next day in the evening i felt some swelling under the jaw on the right side like ulcer on the floor just below the molars . it is very painful

Answered by Dr. Naveen Kumar Nanjasetty (3 hours later)

Hi,

Thanks for the query

The ulcer in the mouth could be an aphthous ulcer.

An aphthous ulcer also known as stress ulcer is a type of mouth ulcer that presents as a painful open sore inside the oral cavity. Sometimes, taking certain oral medications can cause this ulcer.

Do not worry, it can be easily treated. Drink plenty of water; avoid coffee/tea/spicy food. Also, avoid hot and cold drinks for few days. Oral vitamin B12, topical corticosteroids and pain relievers (such as diclofenac or ibuprofen) remain the mainstays of treatment. You can stop Allegra (it causes dryness of the mucosa) for few days and continue with the above measures.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (6 hours later)

thanks sir for replying..i little relieved .its not a open sore its like swelling and is very painful .it is just below the lower jaw under tongue and is very painful

Answered by Dr. Naveen Kumar Nanjasetty (14 hours later)

Hi XXXXXXX

Thanks for writing back

In that case, it could be more of an inflammation of the lymph node supplying in the region of the lower jaw, which is the main cause of your problem.

In my previous response, I had commented presuming it to be an oral ulcer depending upon the description provided by you. If it is not an open ulcer, then the next most likely cause could be the inflammation of the lymph node secondary to some trivial infection in the oral cavity.

Initially, you can try taking some pain relievers such as Diclofenac or Ibuprofen. If it does not subside within a couple of days, then you will require antibiotics (such as a combination of amoxycillin and clavulanic acid) for treatment of the same.

Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (6 minutes later)

Thanks Again ...

Sir the swelling is below right premolars where there is soft area underneath the jaw. I t has been days no improvement. The swelling can be felt by tounge.

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Hi

Welcome back

In the region around the premolars towards the floor of the mouth the structures present are the numerous lymph nodes, submandibular gland, sublingual gland and their ducts.

The possibility of either inflamed lymph node or gland can only be confirmed after an oral examination and digital palpation. The inflammation of the lymph nodes is more common in the region of premolars which can be felt by the tongue. Apart from this, another possibility could be inflamed sublingual or sub mandibular salivary gland or rarely infected minor salivary gland mucocele (sac containing salivary secretions). For all the above conditions the treatment strategy remains the same.

If you are still not satisfied with the answer, you can mail me a snap shot of the swelling, which will be very helpful in making an appropriate diagnosis.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (7 minutes later)

thanks sir ...it is not visible .....there is nothing to woory sir ??

Answered by Dr. Naveen Kumar Nanjasetty (10 minutes later)

Hi XXXXXXX

Thanks for writing back

My XXXXXXX suggestion to you is, not to worry much about this.

I can assure you, it is a relatively harmless inflammatory swelling, just like any other inflammation in the body and it is not XXXXXXX Go ahead with my suggestions, you will definitely be alright.

Wishing you good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (4 days later)

Hello Dr.

Thanks for replying everytime 4 days back i went to dental surgeon for oral checkup,i showed him the swelling he said its an ulcer . I told him that its 6 days im taking BComplex and Rinifol but didnot get any relief. So he prescribed be AZITHRAL OD, DEFLACORT 2times , Flexon 2 times and Limcee 500 mg.. now its 10 days little improvement is seen . I m really tensed . Now should i take Amoxyllin and what should be the dosage .

Thanks in advance

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Hi XXXXXXX

Welcome back

The medicines your dentist has given for the ulcer is alright but along with that you need a local application of oral steroid (such as triamcinolone acetate). It helps in faster healing of the ulcer.

I do not think so you will require any antibiotic, if it is just an oral ulcer. Local steroid application, short course of oral steroids, pain relievers and vitamin B-complex will suffice. If the ulcer does not respond to the above medications then a biopsy of the ulcer has to be taken and sent for testing. Just follow the advice I posted in my first response, you will be fine.

Do not worry! You will be alright. The more you worry, the longer it takes to heal.

Any more doubts, you are welcome. Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (4 minutes later)

for how many days should i wait ?? its been 10 days little improvement the doctor gave me medicine for 3 days . Am very much worried and tensed since i have got this ulcer.

this ulcer came the next day when i took Algerra and nebstar

Answered by Dr. Naveen Kumar Nanjasetty (31 minutes later)

Hi XXXXXXX

Three days of medicine will not suffice, in your list of medicines there is no mention of any oral steroid cream or gel. Until you have used local steroid application, it is difficult for a big ulcer to clear off. Please try this local application and you should be alright. With the proper treatment protocol the ulcer should clear off within a week.

As I have mentioned in my previous response this is stress ulcers which can pop-up with stress, some medications, reduce immunity in the body, smoking, etc. Once the basic problems are taken care of, the ulcer disappears on its own. Nebistar and allegra both can cause ulcers in oral cavity. If you are still taking allegra please discontinue it.

Regards

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (5 minutes later)

Thanks Sir ...
The problem is that i get stressed and worried a lot. When i read on internet the symptoms i got more worried since one month i m very much stressed and worried thats why i had elevated blood pressure so our family doctor prescribed me nebstar . i used to smoke but very less but i have allready quit 1 yr back. I m 27 yrs old are there any risks.

Answered by Dr. Naveen Kumar Nanjasetty (2 hours later)

Hi XXXXXXX

Stress is the main cause for all the health related problems. You can never achieve anything when performed during stress; it actually makes the things worse.
XXXXXXX you are still very young and lots more there to achieve in your life. Stress reduces the immunity in the body due to various changes in the essential hormones, hence paving way for diseases in the body. Definitely stress is a major risk factor for hypertension, cholesterol, diabetes, stroke, cardiac problems, etc. The choice is yours to stay healthy or not.

Try to overcome your stress with meditation, watching comedy movies or serials, exercises and proper planning. You will definitely be healthy and happy.

Wish you good health and good luck.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (10 hours later)

Thanks sir for replying ...Sir i want to know that at this age are there chances of some serious disease related to ulcer. Sir actually i m asking this because i m very much worried as i was light smoker

Answered by Dr. Naveen Kumar Nanjasetty (39 minutes later)

Hi XXXXXXX

It is very unlikely that you can have any serious problems at this age just for smoking. Well, if you are having any other sort of habits like chewing tobacco, pan or jardha along with smoking, then you can land up in trouble.

With mild smoking and aphthous ulcer in the oral cavity, I doubt it can lead to any serious complications. But, it is always wiser to consult your ENT specialist regularly till the ulcer heals off.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (1 hour later)

Yes sir I don't chew any thing I was just a slight smoker

Answered by Dr. Naveen Kumar Nanjasetty (30 minutes later)

Hi XXXXXXX

In that case, do not worry; this could be a stubborn aphthous ulcer not relieving with medicines. It is very unlikely to have a malignant ulcer in this age and with mild smoking habits. Just follow my advice, I can assure, you will be alright soon.

Eat healthy food, plenty of fruits and vegetables, preferably raw sprouted seeds which contain plenty of essential nutrients, enzymes and vitamins.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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. Chakravarthy Mazumdar