[44M] Experiencing severe throat and ear symptoms with systemic issues

Patient Description

A 44-year-old male presents with a constellation of symptoms including shortness of breath, a swollen and sore throat, body tremors, and blood in vomit. The patient reports that the swelling in the larynx has persisted for a couple of weeks, significantly impacting his ability to eat or drink, and describes the sensation as feeling like sandpaper. Despite the duration, no relief has been found for the swelling. Body tremors, described as starting in the hands and then spreading, have been occurring on and off for a few years, with stress exacerbating the condition. Blood has been noticed in the vomit for a few weeks, with the amount of blood varying but recently becoming more frequent and more red. Additionally, the patient experiences coughing, sometimes with blood, and occasional chest pain. There has been a partial loss of hearing in the left ear, which began with pain and drainage of a clear to yellowish liquid approximately 3-4 weeks ago; the drainage ceased after 3 days, but the hearing loss persists. The patient has a history of alcoholism and is a current smoker but is not on any medications and reports no known allergies. Past medications include Seroquel and lithium. The patient expresses concern for the possibility of cancer. Immediate medical evaluation is recommended to address these symptoms and concerns.

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Arora's Assessment

What might be happening

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

  • Gastroesophageal Reflux Disease (GERD): This condition is characterized by stomach acid frequently flowing back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause symptoms such as heartburn, chest pain, difficulty swallowing, regurgitation of food or sour liquid, and coughing. The presence of blood in your vomit could be due to damage to your esophagus or stomach lining caused by the acid reflux.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In severe cases, prescription medications or surgery might be needed.
  • Peptic Ulcer: This is a sore that develops on the inside lining of your stomach, upper small intestine, or esophagus. Peptic ulcers can cause a variety of symptoms, including burning stomach pain, feeling of fullness, bloating, intolerance to fatty foods, heartburn, and nausea. In severe cases, peptic ulcers can lead to vomiting, sometimes with blood present.

    • Treatment typically involves medications to decrease stomach acid and protect the lining of your stomach and duodenum.
  • Laryngitis: This is an inflammation of your voice box (larynx) from overuse, irritation, or infection. Laryngitis can cause voice changes, difficulty swallowing, and a sore throat. In some cases, it can also cause a feeling of a lump in the throat (globus sensation).

    • Treatment typically involves resting your voice and drinking plenty of fluids.
  • Essential Tremor: This is a nervous system (neurological) disorder that causes involuntary and rhythmic shaking. It can affect almost any part of your body, but the trembling occurs most often in your hands. Stress, fatigue, and caffeine can make your tremors more noticeable.

    • Treatment typically involves medications, but in severe cases, surgery might be needed.
  • Ear Infection: This can cause pain in your ear, hearing loss, and a discharge of fluid from your ear. In some cases, it can also cause dizziness and nausea.

    • Treatment typically involves medications to treat the infection and relieve symptoms.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Seek immediate medical attention. The presence of blood in your vomit is a serious symptom that requires urgent evaluation.
  2. Try to avoid foods and drinks that trigger your heartburn. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
  3. Try to eat smaller meals. Avoid eating within 2-3 hours of bedtime.
  4. Try to manage your stress levels. Stress and anxiety can make tremors worse.
  5. Avoid exposure to loud noises and protect your ears from injury to prevent further hearing loss.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe, sudden, or worsening chest pain
  • Difficulty breathing or shortness of breath
  • Vomiting large amounts of blood or dark, coffee-ground-like material
  • Black, tarry stools
  • Sudden, severe headache
  • Sudden, severe abdominal pain
  • Sudden, severe dizziness or fainting
  • Sudden, severe weakness or paralysis in your arms or legs
  • Sudden, severe confusion or trouble understanding speech
  • Sudden, severe trouble seeing in one or both eyes
  • Sudden, severe trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe difficulty swallowing.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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7 mo ago


People Also Ask


What could cause blood in vomit and when should I seek medical attention?

Blood in vomit can be caused by conditions such as gastroesophageal reflux disease (GERD), peptic ulcers, or damage to the esophagus or stomach lining. It is important to seek immediate medical attention if you notice blood in your vomit, especially if it is frequent or accompanied by other severe symptoms like chest pain or difficulty breathing.


How can smoking and alcohol consumption affect my symptoms?

Smoking and alcohol consumption can exacerbate symptoms like throat irritation, acid reflux, and increase the risk of developing ulcers. They can also contribute to the development of more serious conditions, including cancer. Reducing or eliminating these habits can help alleviate symptoms and improve overall health.


What are the potential causes of persistent throat swelling and soreness?

Persistent throat swelling and soreness can be caused by laryngitis, infections, allergies, or irritants such as smoking. It is important to consult a healthcare provider for an accurate diagnosis and appropriate treatment, especially if the symptoms significantly impact your ability to eat or drink.


How can stress impact body tremors and what can be done to manage them?

Stress can exacerbate body tremors, particularly in conditions like essential tremor. Managing stress through relaxation techniques, regular exercise, and possibly medication can help reduce the frequency and severity of tremors. Consulting with a healthcare provider can provide additional strategies tailored to individual needs.

1 Comments


Daisy#15667

7 mo ago

I think you have sufficiently serious symptoms that you will get a proper evaluation (lab tests, chest imaging, and endoscopy of your esophagus and stomach) by going to the emergency room.

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