[22M] With persistent oral and swallowing issues

What might be happening

Based on the symptoms you've described, there are a few potential diagnoses and conditions that could be contributing to your discomfort. Here are some possibilities:

1. Oral Thrush (Candidiasis)

• Rationale: The white coating on your tongue that hasn't improved with antifungal treatment, along with bad breath and a burning sensation in your mouth, could indicate a persistent fungal infection.
• Typical Treatments: Oral antifungal medications, maintaining good oral hygiene, and possibly dietary changes to reduce sugar intake.

2. Gastroesophageal Reflux Disease (GERD)

• Rationale: Your symptoms of heartburn, difficulty swallowing, and a sensation of something stuck in your throat are common in GERD. The burning mouth sensation and bad breath can also be related to acid reflux.
• Typical Treatments: Proton pump inhibitors (PPIs), lifestyle changes such as avoiding spicy foods, and elevating the head while sleeping.

3. Burning Mouth Syndrome

• Rationale: The persistent burning sensation in your mouth, which hasn't responded to treatment, could be indicative of Burning Mouth Syndrome, a condition often linked to stress, nutritional deficiencies, or hormonal changes.
• Typical Treatments: Addressing underlying causes, such as nutritional deficiencies or stress management, and medications to relieve pain.

4. Thyroid Issues

• Rationale: The sensation of a thick throat, hoarseness, and difficulty swallowing could be related to your thyroid cyst, even though your thyroid function tests are normal.
• Typical Treatments: Regular monitoring of the thyroid cyst, and possibly further evaluation if symptoms worsen.

5. Stress and Anxiety

• Rationale: Stress can exacerbate many of your symptoms, including burning mouth syndrome, GERD, and even contribute to weight loss and nausea.
• Typical Treatments: Stress management techniques, such as mindfulness, therapy, and possibly medications for anxiety.

What you can do

For Oral Thrush and Burning Mouth

• Maintain good oral hygiene: Brush your teeth twice a day and use an antiseptic mouthwash.
• Dietary changes: Reduce sugar intake and avoid spicy foods that can irritate your mouth.
• Stay hydrated: Drink plenty of water to keep your mouth moist.

For GERD and Difficulty Swallowing

• Lifestyle changes: Avoid foods and drinks that trigger reflux, such as spicy foods, caffeine, and alcohol.
• Elevate your head while sleeping: Use extra pillows or a wedge to keep your head elevated.
• Eat smaller, more frequent meals: This can help reduce the pressure on your stomach.

For Stress and Anxiety

• Practice stress management: Techniques such as mindfulness, meditation, and deep breathing exercises can help.
• Seek support: Consider talking to a therapist or counselor to manage stress and anxiety.

For Thyroid Issues

• Regular monitoring: Keep up with regular check-ups to monitor the thyroid cyst.
• Report new symptoms: If you notice any new or worsening symptoms, inform your healthcare provider.

What you should look out for

Given the complexity and duration of your symptoms, it's important to seek medical care to get a comprehensive evaluation. Here are some reasons to seek care more urgently:

• Difficulty breathing or shortness of breath: This could indicate a more serious issue with your throat or thyroid.
• Significant weight loss: Continued weight loss without trying can be a sign of an underlying condition.
• Persistent or worsening symptoms: If your symptoms continue to worsen or do not improve with treatment, further evaluation is necessary.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.