[28F] Experiencing swallowing difficulty, tinnitus, and lightheadedness

Patient Description

A 28-year-old female presents with difficulty swallowing without food or liquids, which seems to be exacerbated when lying down. The patient has been experiencing this for a few months and sometimes needs to focus or rub her neck to swallow. Additionally, she reports intermittent, high-pitched tinnitus since July, rated at a 4-5 in severity. Lightheadedness occurs every time she gets up from a lying position, with a severity rating of 8, and has been ongoing for approximately 5 months. The patient also has a mild, persistent cough, feeling the need to clear her throat for a couple of months. There is no fever or chills, no current medications, and no known drug allergies. Past medical history includes a significant liver inflammation episode around 2011 or 2012, suspected to be autoimmune in nature, but no specific diagnosis was confirmed. The patient had liposuction surgery last year.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Dysautonomia: This is a group of conditions that result from a malfunction in the autonomic nervous system, which controls functions like heart rate, blood pressure, and swallowing. Symptoms can include difficulty swallowing, lightheadedness upon standing, and ringing in the ears.

    • Treatment typically involves managing symptoms and can include medications, physical therapy, and lifestyle changes.
  • Gastroesophageal Reflux Disease (GERD): This is a digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. It can cause difficulty swallowing and a persistent cough.

    • Treatment can include lifestyle changes, over-the-counter medications, prescription medications, and in severe cases, surgery.
  • Benign Paroxysmal Positional Vertigo (BPPV): This is a disorder arising in the inner ear, which leads to a sensation of spinning or feeling dizzy. It can occur when changing positions or when getting up.

    • Treatment typically involves a series of movements performed in a doctor's office to help dislodge the tiny calcium particles in the inner ear.
  • Tinnitus: This is the perception of noise or ringing in the ears. It's a common problem and can be caused by a number of things, including age-related hearing loss, ear injury, or a circulatory system disorder.

    • Treatment can involve treating an underlying condition, noise suppression, or medications.

Please note that these are possibilities based on the symptoms you've described and are not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your primary care provider to discuss your symptoms. They may refer you to a specialist if necessary.
  2. Keep a symptom diary. Note when each symptom occurs, its severity, and any potential triggers. This can help your healthcare provider in diagnosing your condition.
  3. Try to stand up slowly from a lying or sitting position. This may help reduce your lightheadedness.
  4. Avoid caffeine, alcohol, and tobacco, which can worsen tinnitus.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe difficulty swallowing or breathing
  • A sudden, severe headache
  • A sudden, severe increase in the ringing in your ears
  • Fainting or loss of consciousness
  • Chest pain or discomfort

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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1 yr ago

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People Also Ask


What could be causing my difficulty swallowing, especially when lying down?

Difficulty swallowing, particularly when lying down, could be due to conditions like dysautonomia or gastroesophageal reflux disease (GERD). Dysautonomia affects the autonomic nervous system, while GERD involves stomach acids backing up into the esophagus.


Why do I feel lightheaded every time I stand up from a lying position?

Feeling lightheaded upon standing could be a sign of dysautonomia, which affects the autonomic nervous system, or benign paroxysmal positional vertigo (BPPV), a condition related to the inner ear.


What are the possible reasons for my persistent cough and need to clear my throat?

A persistent cough and the need to clear your throat could be symptoms of gastroesophageal reflux disease (GERD), where stomach acids irritate the esophagus and throat.


How can I manage the ringing in my ears (tinnitus)?

Managing tinnitus can involve treating any underlying conditions, using noise suppression techniques, or medications. Lifestyle changes, such as avoiding caffeine and loud noises, may also help.


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