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Suggest Treatment For Difficulty In Swallowing, Sore Throat And Cough With Phlegm
Question: All my life my eos and bilirubin have been high on my blood tests. Not super high but a little above the normal range. The doctors originally call the bilirubin elevation 'gilberts syndrome'. As a child I didn't have any major symptoms. Now I am 52, and I am having ongoing coughing producing phlegm. In the past few years I have had several incidents of 'esophagitis' difficulty swallowing. I tested positive in an endoscopy for 'eosinophilic esophagitis'. I had an acute incidence of pancreatitis several years ago. Recently I have been having pains in my back and hips - mild to severe. All of this may not be related, but I am lately feeling like something is generally 'wrong' and perhaps there is some underlying link to all of this.
Also, all my life I get severe sinus like headaches about 4 times a year. Sinuses so swollen that sometimes puts visible pressure on my eye/eyelid.
Any ideas? Is there a common thread and perhaps some curable underlying element?
Thanks,
XXXX
Also, all my life I get severe sinus like headaches about 4 times a year. Sinuses so swollen that sometimes puts visible pressure on my eye/eyelid.
Any ideas? Is there a common thread and perhaps some curable underlying element?
Thanks,
XXXX
Brief Answer:
Needs management. Focus on Eosinophilic Esophagitis
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. This unconjugated hyperbilirubinemia is benign and does not need any treatment. Its genetic and is symptom free at start of age but slight discomfort like you have is noted in advancing age. Clinically XXXXXXX syndrome does not need to be treated but you can take some oral bile salt pills (ursodeoxycholic acid) to help reduce bilirubin.
Having pancreatitis is more likely with hepatobiliary involvement by XXXXXXX and GIT involvement by Eosinophilic Esophagitis. That needs just symptomatic treatment .
Eosinophilic esophagitis is the culprit for most of the symptoms you have. Difficulty swallowing, recurrent sinus infections, bad throat and cough with phlegm. So we need to focus on its management.
As GERD causes cough and sore throat and cough and sinuses recurrent infection, All that can resolve once we control the GERD caused by esophagitis. Symptomatic remedies however like warm hot beverages, herbal teas etc does help the cough and clogged sinuses.
As it is a chronic immune mediated illness you will need lifelong management for it. Reducing diet with dairy and wheat products is a good start. Consult to an allergist or immunologist to give you a complete antigen free dietary plan o help prevent flares of this illness.
Proton pumps inhibitors and topical steroids like budesonide or fluticasone should be taken orally to help relieve the symptoms and reduce eosinophil collection.
If the symptoms of swallowing difficulty still persists next step would be to go for endoscopic balloon dilation of strictures caused by eosinophilic esophagitis.
If you wish you can be a part of many experimental therapies done by many good institutions like mayo clinic or harvard schools of medicine.
Apart from it you need to
1)Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus. If your weight is at a healthy level, work to maintain it. If you are overweight or obese, work to slowly lose weight — no more than 1 or 2 pounds (0.5 to 1 kilogram) a week. Ask your doctor for help in devising a weight-loss strategy that will work for you.
2)Avoid foods and drinks that trigger heartburn. Common triggers, such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine, may make heartburn worse. Avoid foods you know will trigger your heartburn.
3)Elevate the head of your bed. If you regularly experience heartburn at night or while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches. If it's not possible to elevate your bed, insert a wedge between your mattress and box spring to elevate your body from the waist up.
I hope it helps. Take good care of yourself and dont forget to close the discussion please.
Regards
Khan
Needs management. Focus on Eosinophilic Esophagitis
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. This unconjugated hyperbilirubinemia is benign and does not need any treatment. Its genetic and is symptom free at start of age but slight discomfort like you have is noted in advancing age. Clinically XXXXXXX syndrome does not need to be treated but you can take some oral bile salt pills (ursodeoxycholic acid) to help reduce bilirubin.
Having pancreatitis is more likely with hepatobiliary involvement by XXXXXXX and GIT involvement by Eosinophilic Esophagitis. That needs just symptomatic treatment .
Eosinophilic esophagitis is the culprit for most of the symptoms you have. Difficulty swallowing, recurrent sinus infections, bad throat and cough with phlegm. So we need to focus on its management.
As GERD causes cough and sore throat and cough and sinuses recurrent infection, All that can resolve once we control the GERD caused by esophagitis. Symptomatic remedies however like warm hot beverages, herbal teas etc does help the cough and clogged sinuses.
As it is a chronic immune mediated illness you will need lifelong management for it. Reducing diet with dairy and wheat products is a good start. Consult to an allergist or immunologist to give you a complete antigen free dietary plan o help prevent flares of this illness.
Proton pumps inhibitors and topical steroids like budesonide or fluticasone should be taken orally to help relieve the symptoms and reduce eosinophil collection.
If the symptoms of swallowing difficulty still persists next step would be to go for endoscopic balloon dilation of strictures caused by eosinophilic esophagitis.
If you wish you can be a part of many experimental therapies done by many good institutions like mayo clinic or harvard schools of medicine.
Apart from it you need to
1)Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus. If your weight is at a healthy level, work to maintain it. If you are overweight or obese, work to slowly lose weight — no more than 1 or 2 pounds (0.5 to 1 kilogram) a week. Ask your doctor for help in devising a weight-loss strategy that will work for you.
2)Avoid foods and drinks that trigger heartburn. Common triggers, such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine, may make heartburn worse. Avoid foods you know will trigger your heartburn.
3)Elevate the head of your bed. If you regularly experience heartburn at night or while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches. If it's not possible to elevate your bed, insert a wedge between your mattress and box spring to elevate your body from the waist up.
I hope it helps. Take good care of yourself and dont forget to close the discussion please.
Regards
Khan
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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