[37M] With recurrent ear redness, wheezing, and pressure headache

Patient Description

A 37-year-old male presents with recurrent episodes of ear redness and heat occurring multiple times a day, lasting from 30 minutes to 2 hours, without significant pain. He also experiences wheezing that comes and goes, sometimes alleviated by clearing his throat. Additionally, he reports a pressure headache on the sides of his head, rated 7 out of 10 in severity, persisting for 1 day, with no identified triggers or relief methods. The patient feels pressure on the left side of his face around the ear and jaw. He also reports shoulder pain when lifting his bent arm over his head or behind his back, lasting for 1 week, without recent injury. His medical history includes GERD, managed with lansoprazole 30mg daily for 10 years. He has allergies to ciprofloxacin and sulfa drugs. There have been no recent changes in medications, diet, or environment, and no recent travel. A family history of allergies is noted in his brother.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations:

  1. Allergic Reaction or Sinusitis: The combination of ear redness, pressure headache, stuffy nose, and wheezing could suggest an allergic reaction or sinusitis. Allergies can cause nasal congestion and wheezing, while sinusitis can lead to facial pressure and headaches. Treatment typically involves antihistamines for allergies or decongestants and nasal sprays for sinusitis. If symptoms persist, a healthcare provider might recommend allergy testing or imaging studies.

  2. GERD-related Symptoms: Your history of GERD could be contributing to the wheezing, especially if stomach acid is irritating your airways. This is known as "silent reflux." Managing GERD with medications like lansoprazole and lifestyle changes can help reduce these symptoms.

  3. Musculoskeletal Issues: The shoulder pain when lifting your arm could be due to a musculoskeletal issue such as rotator cuff tendinitis or impingement syndrome. These conditions are common and can result from overuse or strain. Treatment often includes rest, physical therapy, and anti-inflammatory medications.

What you can do

Ear Redness and Wheezing:

  • Consider using over-the-counter antihistamines if you suspect allergies.
  • Use a humidifier to keep your airways moist and reduce irritation.
  • Avoid known allergens and irritants as much as possible.

Pressure Headache and Stuffy Nose:

  • Try using saline nasal sprays or a neti pot to clear nasal congestion.
  • Over-the-counter pain relievers like ibuprofen or acetaminophen can help alleviate headache pain.
  • Stay hydrated and rest as much as possible.

Shoulder Pain:

  • Apply ice to the affected area for 15-20 minutes several times a day to reduce inflammation.
  • Avoid activities that exacerbate the pain and consider gentle stretching exercises.
  • If pain persists, consult a healthcare provider for further evaluation and possible physical therapy.

General Advice:

  • Keep a journal of your symptoms using MDandMe to track any changes or patterns. This can be helpful for your healthcare provider.
  • Ensure you are taking your GERD medication as prescribed and follow dietary recommendations to manage symptoms.

What you should look out for

While your symptoms are not immediately life-threatening, you should seek medical attention if you experience:

  • Difficulty breathing or severe wheezing that doesn't improve with usual measures.
  • Persistent or worsening headache, especially if accompanied by vision changes or neurological symptoms.
  • Significant swelling or redness in the shoulder, or if the pain becomes severe.

Remember, while I can provide guidance based on the information you've shared, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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15 d ago


People Also Ask


What could be causing recurrent ear redness and heat without significant pain?

Recurrent ear redness and heat without significant pain could be due to an allergic reaction or sinusitis. Allergies can cause inflammation and increased blood flow to the area, leading to redness and warmth.


How can GERD contribute to wheezing symptoms?

GERD can contribute to wheezing symptoms through a condition known as 'silent reflux,' where stomach acid irritates the airways, leading to wheezing. Managing GERD with medications and lifestyle changes can help reduce these symptoms.


What are some common causes of shoulder pain when lifting the arm?

Common causes of shoulder pain when lifting the arm include rotator cuff tendinitis or impingement syndrome. These conditions often result from overuse or strain and can be managed with rest, physical therapy, and anti-inflammatory medications.


What are effective ways to manage pressure headaches and stuffy nose?

Effective ways to manage pressure headaches and a stuffy nose include using saline nasal sprays or a neti pot to clear congestion, taking over-the-counter pain relievers like ibuprofen or acetaminophen, staying hydrated, and resting.

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