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Suggest Treatment For Severe Gastritis And Upper Abdominal Pain
Question: Dear Doctor
I have been suffering from gastritis and panic disorder for over one year (approximately 1 yr 6 months - 2 years. I believe these conditions are both related to each other because when i was diagnosed with gastritis and severe pain in the upper abdominal i started feeling dizzy and having panic attacks at the same time. i then went onto see a psychiatrist after my consultation with the gastro entomologist who confirmed i have a panic disorder. the doctor initially gave me omeprazole i cannot remember the dosage now but i was taking for one year and then i stopped taking this medicine under the supervision and guidance of the psychiatrist I am seeing. the psychiatrist then prescribed me Escitalopram the branded model called cipralex (SSRI). I have been feeling better since taking this medicine as it has incredibly reduced the anxiety symptoms I used to feel and stopped my panic attacks.
My Psychiatrist doctor could see that I was improving so he decided to take me off the medicine slowly. i reduced my dosage from 25mg daily to 10mg to 5 mg over one month and then eventually stopped the medicine. when i stopped the escitalopram after 1 or 2 weeks I was starting to get severe pain again in my upper abdominal which feels like tightness in the chest as well as feeling severely ill my symptoms included sweaty hands dizziness panic attacks and general feeling of being unwell. I then went back to my psychiatrist doctor who put me back on the medicine and realised it was not yet time to stop the medicine. This incident happened maybe 6/7 months ago. since then I have been taking the escitalopram again 25mg daily.
This experience has left me slightly traumatised and worried if I will be able to stop this medicine soon as my doctor would like to try again for me to stop the medicine in maybe 3/4 months time depending on my condition.
also I have had a fungal nail infection for the past year so my doctor referred me to a dermatologist who prescribed me a medicine called terbinafine 250mg daily to cure the fungal toe nail infection. i have blackheads on my nose so the doctor also prescribed me 1% acid sal 1% resorcinol in spirit to apply to face with cotton pads. also could you tell me if you happen to know if this is good way to cure blackheads?
After three days of taking the terbinafine I started to have tightness in my chest/ upper abdominal pain, anxiety was coming back sweaty palms feeling light headed. I am not sure why this happened maybe you would be able to explain this? I would like to mention that at the same time that I started taking the terbinafine I started taking a multivitamin which had vegetable blend and some ginseng inside it. I do not know which of the two caused the problem I stopped taking both of them In my opinion it was the terbinafine as it was very strong medicine but I am no longer taking the multivitamin also to be on the safe side. I am now only consuming 25mg cipralex and 1 tablet of cod liver oil daily. Since i stopped taking these medicines I have recovered and started to feel better again.
I personally feel that when my stomach lining heals completely My stress levels should go down and this should help reduce anxiety. I am going to try and cut down the sugar I eat and eat more healthy . I had spoken to someone who had gone through similar problem like me and decided to get off the anti depressant medicine they explained to me that for them they were taking ginseng tea, chinese herbal teas, iron tablets and cod liver oil. I went to a chinese herbal store and asked them about ginseng they said this will make my anxiety worser is this true? so i bought papaya herbal tea instead which the chinese doctors were suggesting i should drink twice a day and is good for stomach lining. Since i am sensitive to products I tried once while i was ill from the terbinafine i was taking. I have now recovered and would like to ask if you think it is safe and beneficial for me to drink papaya herbal tea. I would also like to ask based on my condition what I should be eating food wise and if there are any natural supplements that can help my condition?
I have also been told that when i stop taking the anti depressant medicines my hormones become unbalanced and my serotonin levels will decrease.. What can i do as an alternative to keep my hormone balances normal and serotonin levels high so that I do not feel the side effects when I stop this medicine?
could you explain to me what is happening inside my body when i stop the SSRI that is causing me to feel severely ill also so I can understand my situation better.
i do not want to stay on SSRI forever as you know it has its side effects I do not feel as energetic as I used to and my mood is very neutral and emotionless. I want to be medicine free again and healthy. I like going to the gym regularly also and doing weightlifting and cardiovascular exercises like jogging, since my energy levels have been reduced from these medicines I have not been able to go as much as I used to. Would appreciate your help. I am seeing specialist doctors in london but they are also very limited in time when we speak and I am unable to get answers to all my questions sometimes which is why I have come to this website seeking for some information, help and guidance.
any other advice of anything I should be doing will be really helpful whether its lifestyle sleeping pattern, diet, medication etc.
regards
XXXX
I have been suffering from gastritis and panic disorder for over one year (approximately 1 yr 6 months - 2 years. I believe these conditions are both related to each other because when i was diagnosed with gastritis and severe pain in the upper abdominal i started feeling dizzy and having panic attacks at the same time. i then went onto see a psychiatrist after my consultation with the gastro entomologist who confirmed i have a panic disorder. the doctor initially gave me omeprazole i cannot remember the dosage now but i was taking for one year and then i stopped taking this medicine under the supervision and guidance of the psychiatrist I am seeing. the psychiatrist then prescribed me Escitalopram the branded model called cipralex (SSRI). I have been feeling better since taking this medicine as it has incredibly reduced the anxiety symptoms I used to feel and stopped my panic attacks.
My Psychiatrist doctor could see that I was improving so he decided to take me off the medicine slowly. i reduced my dosage from 25mg daily to 10mg to 5 mg over one month and then eventually stopped the medicine. when i stopped the escitalopram after 1 or 2 weeks I was starting to get severe pain again in my upper abdominal which feels like tightness in the chest as well as feeling severely ill my symptoms included sweaty hands dizziness panic attacks and general feeling of being unwell. I then went back to my psychiatrist doctor who put me back on the medicine and realised it was not yet time to stop the medicine. This incident happened maybe 6/7 months ago. since then I have been taking the escitalopram again 25mg daily.
This experience has left me slightly traumatised and worried if I will be able to stop this medicine soon as my doctor would like to try again for me to stop the medicine in maybe 3/4 months time depending on my condition.
also I have had a fungal nail infection for the past year so my doctor referred me to a dermatologist who prescribed me a medicine called terbinafine 250mg daily to cure the fungal toe nail infection. i have blackheads on my nose so the doctor also prescribed me 1% acid sal 1% resorcinol in spirit to apply to face with cotton pads. also could you tell me if you happen to know if this is good way to cure blackheads?
After three days of taking the terbinafine I started to have tightness in my chest/ upper abdominal pain, anxiety was coming back sweaty palms feeling light headed. I am not sure why this happened maybe you would be able to explain this? I would like to mention that at the same time that I started taking the terbinafine I started taking a multivitamin which had vegetable blend and some ginseng inside it. I do not know which of the two caused the problem I stopped taking both of them In my opinion it was the terbinafine as it was very strong medicine but I am no longer taking the multivitamin also to be on the safe side. I am now only consuming 25mg cipralex and 1 tablet of cod liver oil daily. Since i stopped taking these medicines I have recovered and started to feel better again.
I personally feel that when my stomach lining heals completely My stress levels should go down and this should help reduce anxiety. I am going to try and cut down the sugar I eat and eat more healthy . I had spoken to someone who had gone through similar problem like me and decided to get off the anti depressant medicine they explained to me that for them they were taking ginseng tea, chinese herbal teas, iron tablets and cod liver oil. I went to a chinese herbal store and asked them about ginseng they said this will make my anxiety worser is this true? so i bought papaya herbal tea instead which the chinese doctors were suggesting i should drink twice a day and is good for stomach lining. Since i am sensitive to products I tried once while i was ill from the terbinafine i was taking. I have now recovered and would like to ask if you think it is safe and beneficial for me to drink papaya herbal tea. I would also like to ask based on my condition what I should be eating food wise and if there are any natural supplements that can help my condition?
I have also been told that when i stop taking the anti depressant medicines my hormones become unbalanced and my serotonin levels will decrease.. What can i do as an alternative to keep my hormone balances normal and serotonin levels high so that I do not feel the side effects when I stop this medicine?
could you explain to me what is happening inside my body when i stop the SSRI that is causing me to feel severely ill also so I can understand my situation better.
i do not want to stay on SSRI forever as you know it has its side effects I do not feel as energetic as I used to and my mood is very neutral and emotionless. I want to be medicine free again and healthy. I like going to the gym regularly also and doing weightlifting and cardiovascular exercises like jogging, since my energy levels have been reduced from these medicines I have not been able to go as much as I used to. Would appreciate your help. I am seeing specialist doctors in london but they are also very limited in time when we speak and I am unable to get answers to all my questions sometimes which is why I have come to this website seeking for some information, help and guidance.
any other advice of anything I should be doing will be really helpful whether its lifestyle sleeping pattern, diet, medication etc.
regards
XXXX
Brief Answer:
Psychotherapy should be considered.
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding stress and the SSRI effect….in our brain there are several neurotransmitters. Their balance is what determines our mood, buti t is a very complex relationship as they act on different sites and on different receptors, same neurotransmitter may have opposite effects based. For that reason there are still questions to be answered, not all mechanisms are elucidated.
One of the most studied neurotransmitters is serotonin. It is thought that people who have lower levels of serotonin are more prone to anxiety and/or depression. So medication like SSRI which delay serotonin removal increase its levels. Some of the foods I mentioned above which are thoguht to help maintain serotonin levels.
Now to a point serotonin levels are genetically determined so you will always be more prone to anxiety in stressful situations. But you can learn to better cope with it, so that need for medication is diminished. For that reason one measure which you should adopt apart from medication is psychotherapy. Cognitive behavioral psychotherapy sessions are considered as much important as medication in coping with anxiety disorders and panic attacks. So I think that is necessary for you. If you start psychotherapy sessions you will be better equipped to handle the planned withdrawal from SSRI in 3-4 months time.
As for the terbinafine it is not commonly associated with anxiety, at least not directly as it does not have an action on central nervous system. However as you say it is a strong medicine which may produce symptoms like upper abdominal pain, nausea etc which in turn may have triggered stress and anxiety, especially since in the the past gastritis symptoms were related to anxiety so there is a relationship in your mind.
I doubt it was the multivitamin which caused it. Ginseng usually is considered as possibly beneficial for stress as well as increasing energy levels so I am a little surprised you were told that. As for papaya it facilitates digestion of proteins without any side effects, so it can be safely used.
As for what to eat you should try to eat green vegetables as much as possible, tea, fish like salmon and tuna, oatmeal, milk. Avoid caffeine and energy drinks, taking too much sugar and spices.
Natural supplements there are many like valerian, St John’s wort (though these two not advised to be taken for over a month, only when needed), chamomile tea etc to name a few.
Among other lifestyle measure I would suggest yoga as a beneficial activity.
Blackheads are not always that easy to treat. Usually local applications like the one with salicilic acid and resorcinol you were prescribed are the initial safest step, aiming to cleaning and desinfecting the skin. Gel or lotions containing retinoids (retin A, differin) or antibiotics may also be tried if not enough. Only later on if still not working and symptoms are severe enough to affect quality of life may oral medications like antibiotics, isotretinoine (Accutane) or oral contraceptives be tried.
I remain at your disposal for other questions.
Psychotherapy should be considered.
Detailed Answer:
I read your question carefully and I understand your concern.
Regarding stress and the SSRI effect….in our brain there are several neurotransmitters. Their balance is what determines our mood, buti t is a very complex relationship as they act on different sites and on different receptors, same neurotransmitter may have opposite effects based. For that reason there are still questions to be answered, not all mechanisms are elucidated.
One of the most studied neurotransmitters is serotonin. It is thought that people who have lower levels of serotonin are more prone to anxiety and/or depression. So medication like SSRI which delay serotonin removal increase its levels. Some of the foods I mentioned above which are thoguht to help maintain serotonin levels.
Now to a point serotonin levels are genetically determined so you will always be more prone to anxiety in stressful situations. But you can learn to better cope with it, so that need for medication is diminished. For that reason one measure which you should adopt apart from medication is psychotherapy. Cognitive behavioral psychotherapy sessions are considered as much important as medication in coping with anxiety disorders and panic attacks. So I think that is necessary for you. If you start psychotherapy sessions you will be better equipped to handle the planned withdrawal from SSRI in 3-4 months time.
As for the terbinafine it is not commonly associated with anxiety, at least not directly as it does not have an action on central nervous system. However as you say it is a strong medicine which may produce symptoms like upper abdominal pain, nausea etc which in turn may have triggered stress and anxiety, especially since in the the past gastritis symptoms were related to anxiety so there is a relationship in your mind.
I doubt it was the multivitamin which caused it. Ginseng usually is considered as possibly beneficial for stress as well as increasing energy levels so I am a little surprised you were told that. As for papaya it facilitates digestion of proteins without any side effects, so it can be safely used.
As for what to eat you should try to eat green vegetables as much as possible, tea, fish like salmon and tuna, oatmeal, milk. Avoid caffeine and energy drinks, taking too much sugar and spices.
Natural supplements there are many like valerian, St John’s wort (though these two not advised to be taken for over a month, only when needed), chamomile tea etc to name a few.
Among other lifestyle measure I would suggest yoga as a beneficial activity.
Blackheads are not always that easy to treat. Usually local applications like the one with salicilic acid and resorcinol you were prescribed are the initial safest step, aiming to cleaning and desinfecting the skin. Gel or lotions containing retinoids (retin A, differin) or antibiotics may also be tried if not enough. Only later on if still not working and symptoms are severe enough to affect quality of life may oral medications like antibiotics, isotretinoine (Accutane) or oral contraceptives be tried.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for answering my question doctor. I would like to know that when i stop the medicine how i can keep my body in a good state physically to combat the withdrawal symptoms of the medicine and minimalise the side effects as i tried before and had sharp pains in the upper abdominal tightness in chest sweatiness and i felt that my body could not function properly and i could not go about my daily life carrying out the work that i do , it was so bad that i was even unable to drive due to the stress and receiving diziness since iv taken the ssri it has improved the quality of my life as i can now go to work, drive and live without problems. I would like to know when i eventually stop the medicine what i should be doing to keep myself in a state where my body is able to handle the pressure when my hormones are going to be changing due to the serotonin medicine being stopped. Is there anything you would recomend me consuming on a daily basis to prevent myself from suffering during the withdrawal period
Brief Answer:
Psychotherapy again.
Detailed Answer:
Thank you for the feedback!
Actually what you are asking is precisely what I am suggesting psychotherapy will do for you, enabling you to counter the resurgence of the symptoms when you stop the medicine. Cognitive behavioral psychotherapy is aimed precisely in identifying panic and anxiety provoking patterns and relaxation methods in order to prevent those disabling symptoms you mention from affecting your daily life. So that is the best means to avoid what you ask, studies have shown psychotherapy to be at least as beneficial as medication without its side effects.
I understand that you are looking for some supplement, I already mentioned a couple (St John's wort, valerian) previously, but as I said they are for short term use only. Remember that they work through chemicals in them as well, so even though naturally found there is no guarantee of no side effects with long term use, actually one could say that they are even less known and guaranteed on that regard compared to medication which has undergone rigorous testing and studies before entering the market.
That is why I still stress psychotherapy, yoga, relaxation exercises and the foods I mentioned above as the safest method. They may not always be enough, in some patients medication may be needed from time to time, but they are the best means in avoiding that need.
Let me know if I can further assist you.
Psychotherapy again.
Detailed Answer:
Thank you for the feedback!
Actually what you are asking is precisely what I am suggesting psychotherapy will do for you, enabling you to counter the resurgence of the symptoms when you stop the medicine. Cognitive behavioral psychotherapy is aimed precisely in identifying panic and anxiety provoking patterns and relaxation methods in order to prevent those disabling symptoms you mention from affecting your daily life. So that is the best means to avoid what you ask, studies have shown psychotherapy to be at least as beneficial as medication without its side effects.
I understand that you are looking for some supplement, I already mentioned a couple (St John's wort, valerian) previously, but as I said they are for short term use only. Remember that they work through chemicals in them as well, so even though naturally found there is no guarantee of no side effects with long term use, actually one could say that they are even less known and guaranteed on that regard compared to medication which has undergone rigorous testing and studies before entering the market.
That is why I still stress psychotherapy, yoga, relaxation exercises and the foods I mentioned above as the safest method. They may not always be enough, in some patients medication may be needed from time to time, but they are the best means in avoiding that need.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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