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Treated for alcohol induced gastritis. Taking Omeprazole. Having dry mouth, tired and washed out. Suggest?

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I was recently treated for alcohol induced gastritis after a single incident of drinking half a dozen After Shock shots at my 60th Birthday party. Having completed 4 weeks of taking Omeprazole, I still have a very dry mouth, especially affect eating and feel very tired and washed out after a good night's sleep. I have not had any alcohol since my Birthday, which was 8 weeks ago now.
Posted Sat, 1 Jun 2013 in Digestion and Bowels
 
 
Answered by Dr. Shoaib Khan 3 hours later
Hello and welcome to XXXXXXX

Thank you for writing to us.

I have gone through your query, and would like to first of all congratulate you on turning 60, and then for the abstinence from alcohol. Both great feats.

Now coming to your symptoms of dry mouth and fatigue. The most common causes for these symptoms are:
-Dehydration (have you been drinking fluids well enough; at least 3-4 liters a day)
-Medication related side-effects (although you have mentioned to be only on omeprazole, there have been no reported side-effects of dry mouth and fatigue with this medication)
-Vitamin deficiency (occurs with gastritis; especially vitamin B12)
-Anemia (also seen in patients with gastritis)
-Low blood sugar (due to a low intake, seen in patients with gastrointestinal problems with a decreased appetite; gastritis also causes a drop in appetite)
-Low nutrition

Although there exist many other causes, I have listed the most likely ones. Please keep yourself hydrated and visit your doctor to investigate your hemoglobin, vitamin levels, and blood sugar. Consume green leafy vegetables and less acidic fruits.

I hope you found my response helpful and informative. Do write back to me for any further clarifications, I would be more than happy to help you.

Best wishes.
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Follow-up: Treated for alcohol induced gastritis. Taking Omeprazole. Having dry mouth, tired and washed out. Suggest? 14 hours later
Thank you for the feedback. Please advise whether it could be the onset of Diabetes, as I have also experienced itching in the groin area overnight. This does not happen every night and I have no visible rash. Could one episode of drinking shots cause the onset of Diabetes given Aftershock is 40% alcohol?
 
 
Answered by Dr. Shoaib Khan 8 hours later
Hello sir and welcome back.

As listed above, your current presentation also matches low blood sugar (hypoglycemia). But, please note that this doesn't mean you have diabetes. Any healthy individual can have an attack of hypoglycemia when they are starving, eating less and exercising more, having alcohol on an empty stomach, etc.

The itching in the groin area does not directly point towards diabetes. But, it is possible for you to have hypoglycemia as there is a drop in appetite in individuals suffering from gastritis, which in turn can result in hypoglycemia.

Also sir, as mentioned above, if you had the 'Aftershock' on an empty stomach, there is a high possibility for you to have developed hypoglycemia along with the gastritis. But, on night of 'Aftershock' shots, or alcohol overdose cannot cause diabetes, but can cause an imbalance in the blood sugar, which might take time to normalize.

If your symptoms of dry mouth, weakness, tiredness, lethargy, etc; persist I would advice you to visit your doctor to find the cause. Also, you could request for a glycemic profile to be conducted. This will give us a clear picture on your blood sugar status (diabetes).

I hope you found my response helpful. You could write back to me with any further clarifications, or rate my answers after closing this discussion.

Wishing you a speedy recovery sir,
Take care.
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Follow-up: Treated for alcohol induced gastritis. Taking Omeprazole. Having dry mouth, tired and washed out. Suggest? 2 days later
Thank you. I have seen my Dr and he has recommended a blood test and 'Well man' analysis for a 60 year old, which should cover all the potential conditions you have mentioned. However, since seeing him on Thursday, I have noticed that eating certain foods is causing a recurrence of the Gastritus, with some indigestion and a very full feeling in my throat and upper osophigus; this combined with the exceptional dryness in my mouth, both generally and especially after eating, leads me to believe I may still have acid leakage following the initial Aftershock incident. It is particularly concerning, as I never suffered from eating or over eating before my 60th Birthday. Can you advise further on this please?
 
 
Answered by Dr. Shoaib Khan 14 minutes later
Hello once again sir.

Good to know that you are going for a full medical check-up which should be really helpful. This is a good thing to do, not just now, but at least once a year once you cross the age of 50 years. Please do let me know the results.

Now coming to your current complaints. It appears as though you are suffering from acid reflux. Let me state a few symptoms for you of a condition resulting from acid reflux:
-Dry cough
-Burning sensation in chest (heartburn), can spread to throat as well
-Sour taste in mouth
-Difficulty in swallowing
-Hoarseness of voice
-Feeling of something in throat
-Sore throat
-Regurgitation of food of liquid with a bitter taste in mouth

If you do think that this could be the case, I think you should also request for an 'ambulatory acid (pH) probe test using an acid-measuring device. This will further help in diagnosing/ruling out acid reflux.

In the meantime, please avoid:-Oily/fatty/fried food
-Food and drinks containing citrus
-Drinks containing caffeine
-Avoid heavy and large meals
-Drink lots of water

You could also request your doctor to initiate a course of any of the following medications:
-Antacids (eg. gelusil), they are aluminium/magnesium containing medications
-H2 receptor blockers (eg. ranitidine, famotidine, etc.)
-Proton pump inhibitors (eg. lansoprazole, omeprazole, etc.)

I hope you found my response helpful and informative, if you have any further clarifications, please write back to me and I would be glad to assist you. Or if I have succeeded in answering your queries, you could close this discussion and rate my answer.

Best wishes.
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Follow-up: Treated for alcohol induced gastritis. Taking Omeprazole. Having dry mouth, tired and washed out. Suggest? 2 days later
Thank you once again. Before going back to my Dr, can you advise whether permanent damage is possible from just one episode of drinking high alcohol Aftershock on a relatively empty stomach. It has been over nine weeks since my Birthday and my symptoms still persist. Is it just a case of waiting or should I be worried?
 
 
Answered by Dr. Shoaib Khan 2 hours later
Hello sir and welcome once again.

Clinically many patients present with symptoms for quite some time, this should not be anything to worry about, as no permanent damage can take place.

This is all an imbalance. And once the balance is restored (i.e. when you return to your normal diet, exercise, etc; basically your normal regimen), all your functions should return to normal.

Are you still eating limited portions of food in fear of your gastritis flaring up? Or due you still not have a good appetite (like before the incident)?

If so, I can understand. And once your gastritis is controlled, your food intake should return to normal.

Now another aspect of looking at the whole thing, is if you had any such condition, which was undiagnosed, and has now flared up since the incident (eg. diabetes). So please do get your glycaemic profile, especially an investigation called HbA1c, which is a predictor of diabetes, and can also provide information on whether or not it was previously present.

Do not worry sir. I am sure you will soon recover completely. I wish you a speedy recovery and a healthy life thereafter.

I hope you found my response helpful and informative. Do write back to me for any further clarifications, or you could rate my answers after closing this discussion.

Best wishes.
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Follow-up: Treated for alcohol induced gastritis. Taking Omeprazole. Having dry mouth, tired and washed out. Suggest? 21 hours later
Thank you once again. However, I realise you need to know more about me. Although I am 60, I still play cricket in the Summer and go to yoga once a week to avoid back problems. I am 6ft 2in, a fairly slim build and my weight varies between 13.5 stone in the Winter months to 12.5 stone at the end of the Summer. I have not lost any appetite since I have been feeling unwell and I am eating healthily, as I always have done.

It is also important for you to know that I have not had any heartburn, even though I have experienced the other symptoms of Gastritus in my throat. The main concern is a very dry throat immediately following a meal and I am still waking up with an uncomfortable throat and flu like symptoms in my head. These abate when I get up and move around, becoming less concerning through the day. I trust this extra information will help pinpoint the problem better.
 
 
Answered by Dr. Shoaib Khan 4 hours later
Thank you so much for the information.

From all the information provided, the symptoms do not seem like this could be something to do with your blood sugar.

But, sadly your description is not sufficient enough to pin point a diagnosis, this could be anything. A reaction to the acid reflux from the gastritis (monitor 24 hours pH) or some infection as well.

I would recommend a routine blood test if you do not mind, this can provide information on any infections or general abnormalities in the body. If all returns normal, this could be more of a late response to the gastritis.

The fact that all or most of your symptoms reduce/abate as you go about your routine, points in the direction of an acid reflux or any other gastrointestinal problem. This might have to be investigated depending on the routine blood investigation reports.

In the meantime, please consume plenty of water and other non-acidic fluids.

Do write back to me after the routine blood investigations, with the reports.

Best wishes.
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Follow-up: Treated for alcohol induced gastritis. Taking Omeprazole. Having dry mouth, tired and washed out. Suggest? 18 hours later
All understood and I agree, it seems more like a continuance of the Gastritus than anything else. I have the well man blood test tomorrow and we will know more once it is analysed. Just one last question for now: is it possible or even common to have Acid Reflux symptoms in the throat without any heartburn?
 
 
Answered by Dr. Shoaib Khan 3 hours later
Hello once again sir.

All human beings are different. In their presentation, speech, characteristics, fingerprint, and so on. Similarly, it is not necessary that all individuals have similar presentations to a particular condition.

All symptoms of a particular condition listed in medical textbooks are those which have been commonly reported. It is not necessary for all individuals to present with all the symptoms.

Although heartburn is one of the most common symptoms, it could be possible for an individual who might be suffering from acid reflux to present without it.

Do not worry about this sir. Wishing you lots of luck for tomorrow's Well Man's checkup. Do keep me informed sir.

Take care sir.
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Follow-up: Treated for alcohol induced gastritis. Taking Omeprazole. Having dry mouth, tired and washed out. Suggest? 10 days later
Further to your previous advice, I visited my GP and my blood test was normal across all the respective well man risk areas. The only question arose on my kidney scoring, which will be checked again in four weeks to see if there is any continuing abnormality. Looking at the various web feedback on my continuing very dry mouth and general flu like symptoms, it is very unliely that the kidney scoring has any relevence, as I have no abdominal pain. My GP thinks the condition will 'go away' over time and is not concerned, but as I have healthcare insurance, I am considering asking for a referral to investigate acid reflux. Would you support this move and if so, what should I ask for?
 
 
Answered by Dr. Shoaib Khan 6 hours later
Hello once again sir.

It is great that most of your parameters from the health check up are normal. But, a general health check up does not look into more specific conditions, which means it has not checked on conditions like gastritis, acid reflux disease, etc.

I would support the investigation of acid reflux a 100%. These are the following tests used to diagnose acid reflux, and some have other benefits as well:
-Barium swallow x-ray of your upper digestive system (will help in finding any abnormalities in the walls of the upper digestive system, which could have resulted from acid reflux)
-Endoscopy: In this procedure we pass a flexible tube down your throat, fitted with a camera to visualize the insides of your digestive system. This can help in finding ulcers, gastritis, acid reflux disease, hiatus hernia, and a host of other conditions.
-Ambulatory acid (pH) probe tests: This will measure the amount of acid produced in 24 hours and compare it to acceptable levels
-Esophageal motility testing: To check the pressure and motility of your food pipe

I hope you found my response helpful and informative. Do write back to me for any further clarifications, or you could rate my answers after closing this discussion.

Best wishes.
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