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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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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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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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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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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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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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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