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Suggest Treatment For Severe Difficulty In Swallowing While Experiencing General Anxiety
Posted on
Wed, 21 Dec 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Wed, 21 Dec 2016
Answered on
Sat, 7 Jan 2017
Last reviewed on
Question : I have had a lot of medical issues these past 4 months. If you look below. My question now is my voice has been hoarse for the past three months. I was told at first that it was my anxiety but I feel that is is something else. I also have trouble swallowing. There is no pain of any kind. Just annoying. I can eat but I notice it when i am not eating. what could it be?
Brief Answer:
Information
Detailed Answer:
Hello,
Regarding your 3 months of hoarse voice and change in swallowing, there are a few things to consider:
If you have ongoing post nasal drainage, such as from allergies or an infection in the sinuses, that can cause these changes.
But I noticed you reported an inflamed stomach and gastric ulcer. Given that, it's possible that you have been having silent gastric reflux and acid is coming into the back of your throat. This is called laryngopharyngeal reflux. I am assuming the Pantoprazole was just prescribed today? It may help your problem soon.
If it doesn't, your hoarseness should be looked into. Things to check are your thyroid gland for size (by palpation) and function (blood test). And if these are normal, then the next step is to see an ENT (otolaryngologist).
Also, if you smoke cigarettes, this can cause these symptoms too.
Was your weight loss intentional and if not, what was the cause?
Another question: you mention you had CT scans, ultrasounds, etc. Of what part of the body - was this for evaluating your hoarseness or weight loss?
Information
Detailed Answer:
Hello,
Regarding your 3 months of hoarse voice and change in swallowing, there are a few things to consider:
If you have ongoing post nasal drainage, such as from allergies or an infection in the sinuses, that can cause these changes.
But I noticed you reported an inflamed stomach and gastric ulcer. Given that, it's possible that you have been having silent gastric reflux and acid is coming into the back of your throat. This is called laryngopharyngeal reflux. I am assuming the Pantoprazole was just prescribed today? It may help your problem soon.
If it doesn't, your hoarseness should be looked into. Things to check are your thyroid gland for size (by palpation) and function (blood test). And if these are normal, then the next step is to see an ENT (otolaryngologist).
Also, if you smoke cigarettes, this can cause these symptoms too.
Was your weight loss intentional and if not, what was the cause?
Another question: you mention you had CT scans, ultrasounds, etc. Of what part of the body - was this for evaluating your hoarseness or weight loss?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The ct scans ultra sounds and x-rays were done because of my weight loss, the stomach area was the part of the body tested. cancer was suspected but all tests were negative blood tests were done suspected my thyroid, it was negative. When my anxiety and depression hit I did eat healthy and my weight just dropped fast. I wanted to lose weight but not like this. I think the combination at the time did it. I do not have trouble with any gastric reflux, but I forgot to mention that I have a small hiatus hernia. I don't know if this at times give me shortness of breath, now I have been hoarse for the past three months. I plan to see an ENT doctor asap.I have had one thing after another.
Brief Answer:
Information
Detailed Answer:
I'm sorry you have had so much going on, but you may be better soon.
Sometimes people have "silent" reflux, without knowing it. I am thinking about this because of the gastritis/ulcer and hiatal hernias can increase the risk too.
Yes, seeing an ENT is the next step.
I hope you are doing well soon. If you are willing, please let me know how you are doing after seeing the ENT.
Information
Detailed Answer:
I'm sorry you have had so much going on, but you may be better soon.
Sometimes people have "silent" reflux, without knowing it. I am thinking about this because of the gastritis/ulcer and hiatal hernias can increase the risk too.
Yes, seeing an ENT is the next step.
I hope you are doing well soon. If you are willing, please let me know how you are doing after seeing the ENT.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
There is no doubt that you care about your patients. They are lucky to have you. Dr. Can A hiatal hernia affect your breathing? Sometimes I feel that I'm short of breath or its hard to get a deep breath. Everybody says its your anxiety. Well maybe I don't know. I heard you can have surgery to correct it. But for now, I can still lifts weights right?
Brief Answer:
Information
Detailed Answer:
Thank you for your kind words!
A hiatal hernia can definitely cause shortness of breath in some people. If the hernia allows the stomach to push up on the diaphragm, this can give a feeling of shortness of breath. Some people feel this especially when lying down and it triggers a feeling of panic.
Regarding hiatal hernia surgical repair: the procedure has improved since I was in medical school, at which time it seemed to cause as much trouble as it helped. I am not sure where things are at with it's efficacy now but I understand it is better. If you do decide to go ahead with it, make sure to find a surgeon who does many of these procedures specifically, and ask him or her their success rate.
Now about the weight lifting: some people with hiatal hernias find that lifting their arms up overhead (and especially if holding weights) exacerbates their symptoms. If you have lifted weights overhead and have not had any problems (no increase in shortness of breath sensation or with throat hoarseness), then I'd say go ahead, just do so slowly with caution.
Information
Detailed Answer:
Thank you for your kind words!
A hiatal hernia can definitely cause shortness of breath in some people. If the hernia allows the stomach to push up on the diaphragm, this can give a feeling of shortness of breath. Some people feel this especially when lying down and it triggers a feeling of panic.
Regarding hiatal hernia surgical repair: the procedure has improved since I was in medical school, at which time it seemed to cause as much trouble as it helped. I am not sure where things are at with it's efficacy now but I understand it is better. If you do decide to go ahead with it, make sure to find a surgeon who does many of these procedures specifically, and ask him or her their success rate.
Now about the weight lifting: some people with hiatal hernias find that lifting their arms up overhead (and especially if holding weights) exacerbates their symptoms. If you have lifted weights overhead and have not had any problems (no increase in shortness of breath sensation or with throat hoarseness), then I'd say go ahead, just do so slowly with caution.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Because of my depression my doctor had given me Zoloft to take. How do you feel about this drug. I understand it is not addictive but what are the side effects. I would really like your honest opinion. Also, because of my weight loss, the doctor who did my colonoscopy didn't find much wrong. He said that depression is the problem. I eat three times a day , could it be the depression you think?
Brief Answer:
Information about Zoloft and meds in it's class (SSRIs)
Detailed Answer:
Zoloft is a good medication for depression. It is an SSRI and of the early 3 (Prozac, Zoloft, Paxil) may have fewer side effects. I usually prescribe Lexapro (escitalopram) which is newer and seems to have even fewer side effects and a faster initiation for helping symptoms. But Zoloft is good too.
It is not addictive, but as with any SSRI, you do have to take it daily. And if/when you go off of it, you need to taper it.
When starting an SSRI, if people tend to be sensitive to meds, I advise them to start on a low dose and then increase the dose after a couple of weeks.
Common side effects of SSRIs are weight gain (Paxil is the worst for this), sometimes weight loss but that is less common. Some experience sweating.
Common side effects are dry mouth, and one side effect that can be a concern is sexual problems (decreased libido, difficulty maintaining an erection, delayed orgasm). Some people find the benefit of the SSRI for their depression is worth the risk of this, and please keep in mind not all people get all of these side effects.
Another area of the body SSRIs can affect is the gastrointestinal tract. This can include nausea and diarrhea. These side effects usually go away in the first couple weeks, or at least mostly do.
For some it can help sleep, and for others, cause insomnia. More likely to help though.
So it boils down to if you find these things are worth risking to help your depression. But keep in mind, many people take SSRIs and do not experience significant side effects.
Zoloft will take a few weeks for onset of action. Lexapro (escitalopram) kicks in sooner, usually within the first two weeks.
About your weight loss, if you have been eating fewer calories overall at each meal, then yes, it can cause weight loss.
I assume someone checked your thyroid function?
Information about Zoloft and meds in it's class (SSRIs)
Detailed Answer:
Zoloft is a good medication for depression. It is an SSRI and of the early 3 (Prozac, Zoloft, Paxil) may have fewer side effects. I usually prescribe Lexapro (escitalopram) which is newer and seems to have even fewer side effects and a faster initiation for helping symptoms. But Zoloft is good too.
It is not addictive, but as with any SSRI, you do have to take it daily. And if/when you go off of it, you need to taper it.
When starting an SSRI, if people tend to be sensitive to meds, I advise them to start on a low dose and then increase the dose after a couple of weeks.
Common side effects of SSRIs are weight gain (Paxil is the worst for this), sometimes weight loss but that is less common. Some experience sweating.
Common side effects are dry mouth, and one side effect that can be a concern is sexual problems (decreased libido, difficulty maintaining an erection, delayed orgasm). Some people find the benefit of the SSRI for their depression is worth the risk of this, and please keep in mind not all people get all of these side effects.
Another area of the body SSRIs can affect is the gastrointestinal tract. This can include nausea and diarrhea. These side effects usually go away in the first couple weeks, or at least mostly do.
For some it can help sleep, and for others, cause insomnia. More likely to help though.
So it boils down to if you find these things are worth risking to help your depression. But keep in mind, many people take SSRIs and do not experience significant side effects.
Zoloft will take a few weeks for onset of action. Lexapro (escitalopram) kicks in sooner, usually within the first two weeks.
About your weight loss, if you have been eating fewer calories overall at each meal, then yes, it can cause weight loss.
I assume someone checked your thyroid function?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes they did blood work to see if it was my thyroid and it came back negative. You are right I am one of those people that don,t like any medicines. I don't even like taking an aspirin for a headache, so you can understand my concern about Zoloft or any drug. As for the Lorazapan I have been weaning off for the past month. How can you really tell that you don't need it no more? Even with the Zoloft when can you stop taking it or winding down off of it?
Brief Answer:
Information
Detailed Answer:
With the Lorazepam, when you get to half of the lowest dose (i.e. 0.25 mg) and no longer feel jittery or anxious, then you should be fine to go off of it.
With Zoloft, you will need to stay on it for at least 3-6 months after starting it for therapeutic effect and at that point you would need to slowly taper. However, if you find that you are not liking it shortly after starting it, you can go off of it quickly, usually without much of a taper.
Information
Detailed Answer:
With the Lorazepam, when you get to half of the lowest dose (i.e. 0.25 mg) and no longer feel jittery or anxious, then you should be fine to go off of it.
With Zoloft, you will need to stay on it for at least 3-6 months after starting it for therapeutic effect and at that point you would need to slowly taper. However, if you find that you are not liking it shortly after starting it, you can go off of it quickly, usually without much of a taper.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. last question, I would have to take Zoloft for that long? I just saw my medicine since I got ti today. They gave me Sertraline HCL 50 mg Tablets, I assume this is a generic brand? Is this a cheaper version? Is it like Zoloft?
Brief Answer:
Information
Detailed Answer:
Yes, with SSRIs are usually given for 6 months to treat depression.
Sertraline is the chemical name for the medicine in Zoloft and is sold by the chemical name for it's generic form. It is less expensive than brand name.
50 mg is a typical starting dose. If you are worried about trying it, you can take half of that for a few days and see. But it's benefits won't kick in for a few weeks.
Information
Detailed Answer:
Yes, with SSRIs are usually given for 6 months to treat depression.
Sertraline is the chemical name for the medicine in Zoloft and is sold by the chemical name for it's generic form. It is less expensive than brand name.
50 mg is a typical starting dose. If you are worried about trying it, you can take half of that for a few days and see. But it's benefits won't kick in for a few weeks.
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
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