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What Causes Nausea And Spasms In Espophagus After Having Antibiotics?
Question: My doctor has prescribed an antibiotic called mylan-clarithromycin (500mg) for a chronic cough for 6 months. This is the third round of antibiotic. I have had three chest xrays - all normal. In the meantime, I was referred to a ENT who suspected laryngopharyngeal reflux (LPR). I was having symptoms of the cough, ear problems, what felt like spasms of the esophagus, nausea, and fairly severe back pain particularly after eating. My cough is only present during the day and particularly bad after meals.
I have cut out all alcohol caffeine spicy foods etc. and raised the head of my bed in attempt to relieve symptoms for over a week. In addition I have been taking 20mg of Omeprazole (PPI). There has been no reductions in symptoms, in fact it seems to have gotten worse on the antibiotic.
This background information leads me to these questions:
1. Can I discontinue my antibiotic treatment? I have been on them for 4 days. It is a 10 day regimen.
2. Can LPR be a result of anxiety and can it be successfully treated with antidepressants? I had a lot of anxiety over a major decision when my cough came on 6 months ago. In addition, I had been on antidepressants for health anxiety almost 15 years ago. I have similar symptoms (of anxiety, not physical) to that time. I wondering if this was brought on by stress and now that I am anxious it will only be relieved with medication to treat the anxiety.
3. If LPR could be treated with antidepressants, which would make most sense?
4. What are the chances of developing Barret's esophagus or cancer as a result of LPR? I suspect I may have had this for over a decade due to the fact that I have had constant throat clearing.
5. Any other thoughts on how I might cure LPR or relieve symptoms?
6. My doctor also prescribed flovent for the cough. Can this increase LPR/GERD?
Thank you in advance.
Regards,
XXXXXX
I have cut out all alcohol caffeine spicy foods etc. and raised the head of my bed in attempt to relieve symptoms for over a week. In addition I have been taking 20mg of Omeprazole (PPI). There has been no reductions in symptoms, in fact it seems to have gotten worse on the antibiotic.
This background information leads me to these questions:
1. Can I discontinue my antibiotic treatment? I have been on them for 4 days. It is a 10 day regimen.
2. Can LPR be a result of anxiety and can it be successfully treated with antidepressants? I had a lot of anxiety over a major decision when my cough came on 6 months ago. In addition, I had been on antidepressants for health anxiety almost 15 years ago. I have similar symptoms (of anxiety, not physical) to that time. I wondering if this was brought on by stress and now that I am anxious it will only be relieved with medication to treat the anxiety.
3. If LPR could be treated with antidepressants, which would make most sense?
4. What are the chances of developing Barret's esophagus or cancer as a result of LPR? I suspect I may have had this for over a decade due to the fact that I have had constant throat clearing.
5. Any other thoughts on how I might cure LPR or relieve symptoms?
6. My doctor also prescribed flovent for the cough. Can this increase LPR/GERD?
Thank you in advance.
Regards,
XXXXXX
Brief Answer:
All queries addressed sir, best of luck
Detailed Answer:
Hello sir and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. I am sorry to hear about your distressing symptoms and would be more than happy to answer your queries sir.
1. I do not see any indication for antibiotics, unless your reflux has caused any infections (which should have symptoms like fever), I think you can discontinue the antibiotics. But I would also like to let you know that antibiotics can easily cause gastric irritation, even in individuals who do not have any pre-existing gastric conditions, which is why antacids (e.g. omeprazole, pantoprazole, etc.) are prescribed.
So as you have a pre-existing gastric condition, you need a higher dosage of antacids.
2. Yes, LPR can be caused by anxiety and anti-depressants can help. Anxiety can cause an increased production of acid in the stomach and can easily cause damage to your stomach sphincters resulting in reflux
3. Firstly, please do not self-medicate sir and if at all you are ready to take anti-depressants then consult your doctor for the medication. But some good options would be sertraline, escitalopram, paroxetine, fluoxetine, etc.
4. Barrett's esophagus occurs due to acid reflux occurs rarely and in my opinion carries only a 5-10 % chance. As for cancer from LPR, less than 1 %.
5. Options include:
+Head elevation in bed (as you already know sir), this should be about 6 inches
+Wear loose and comfortable clothes, especially around the waist
+Avoid stress, and learn some relaxation techniques
+Avoid alcohol
+Avoid smoking
+Try not to throw up as much as possible
+Have early and light dinner, leave a gap of about 2-3 hours prior to bedtime which should be without consumption of food or drink
+Keep chewing or sucking something
+Medications like H2 blockers or proton-pump inhibitors should be taken on a regular basis
+Rest well after a meal
+5-6 smaller meals in a day, instead of 2-3 large meals
+Never overeat
+Weight loss (only if you are overweight)
+Avoid vigorous exercise
+Initiate sucrlafate syrup, this has shown to really help in many of my patients. To be taken 15 minutes before each meal every day, three times a day for at least 6 months religiously
6. No sir, flovent will certainly help.
I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help.
Best wishes.
All queries addressed sir, best of luck
Detailed Answer:
Hello sir and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. I am sorry to hear about your distressing symptoms and would be more than happy to answer your queries sir.
1. I do not see any indication for antibiotics, unless your reflux has caused any infections (which should have symptoms like fever), I think you can discontinue the antibiotics. But I would also like to let you know that antibiotics can easily cause gastric irritation, even in individuals who do not have any pre-existing gastric conditions, which is why antacids (e.g. omeprazole, pantoprazole, etc.) are prescribed.
So as you have a pre-existing gastric condition, you need a higher dosage of antacids.
2. Yes, LPR can be caused by anxiety and anti-depressants can help. Anxiety can cause an increased production of acid in the stomach and can easily cause damage to your stomach sphincters resulting in reflux
3. Firstly, please do not self-medicate sir and if at all you are ready to take anti-depressants then consult your doctor for the medication. But some good options would be sertraline, escitalopram, paroxetine, fluoxetine, etc.
4. Barrett's esophagus occurs due to acid reflux occurs rarely and in my opinion carries only a 5-10 % chance. As for cancer from LPR, less than 1 %.
5. Options include:
+Head elevation in bed (as you already know sir), this should be about 6 inches
+Wear loose and comfortable clothes, especially around the waist
+Avoid stress, and learn some relaxation techniques
+Avoid alcohol
+Avoid smoking
+Try not to throw up as much as possible
+Have early and light dinner, leave a gap of about 2-3 hours prior to bedtime which should be without consumption of food or drink
+Keep chewing or sucking something
+Medications like H2 blockers or proton-pump inhibitors should be taken on a regular basis
+Rest well after a meal
+5-6 smaller meals in a day, instead of 2-3 large meals
+Never overeat
+Weight loss (only if you are overweight)
+Avoid vigorous exercise
+Initiate sucrlafate syrup, this has shown to really help in many of my patients. To be taken 15 minutes before each meal every day, three times a day for at least 6 months religiously
6. No sir, flovent will certainly help.
I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help.
Best wishes.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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