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Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Endocrinology
Satisfied Customers: 11880
Experience:  Have experience of Endocrinology over the last 3 years
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Not for Dr Phil, please. I had a virus cold and sore throat

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Not for Dr Phil, please.I had a virus cold and sore throat last week, bronchitis 2 weeks before. This last Tuesday I was taking a bunch of pills, like 8, I take a lot of them everyday. These were vitamins (D and B), a biaxcin, and Allegra. They got stuck in the lower esophagus and it hurt very bad. I have sjogrens and have very little saliva production. It hurt there and I had a lot of burping afterwards and the next day and then my husband who had checked my throat two days prior checked my throat again because it hurt bad to swallow and it was covered with white spots and a white area on roof of the mouth. I also wear dentures, lost all my teeth last year due to the sjogrens dryness, and no good bacteria. Anyways went to urgent care Thursday night and he diagnosed me with thrush and put me on difucan for 3 days, said if it does not clear up I could have in my espohogas and may need and endoscopy. I took 2 days of diflucan and the spots were gone by Friday night. They are still gone now. But I am still burping after meals more than usual. I have had chest X-rays this year, should those have shown a hiatel hernia?, he mentioned that could cause this. I also had been using a steroid based inhaler for two weeks prior and not rinsing my mouth, and have dry mouth and dentures, which all can cause thrush.

Dear customer,

Thank you for the question.

Clearly, you have many possible causes that have lead to the development of thrush. Your continued burping will also reduce gradually in a few days. Its continued presence even with treatment is not alarming or concerning. If your difficulty in swallowing has improved then you should not worry regarding the continued burping which will also resolve in a few days. Chest x-rays may detect a possible hiatal hernia.

Take care.

Please let me know if you have further queries or unanswered questions.
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Customer: replied 10 months ago.
I took diflucan for 2 days, if you see the two pictures below, you can see before and 1 day after the diflucan.1.Could the stuck pills have aggravated my lining causing the burping? 5 days later?2.is it likely that if it had gone down the esophagus that it would come back up the throats when I went off difucan after two days? or more likely thrush in the mouth only?3.can a hiatial hernia come on fast out of the blue?
Customer: replied 10 months ago.
if you can't answer can you open my question up, thank you
Customer: replied 10 months ago.
for Dr Love or Dr Ali

Hello again,

First off thank you for the kind words in the other thread. Secondly, I'm happy to see that your thrush has cleared up nicely. Now coming to your questions.

1) Actually, the simple answer here is that YES, many pills can cause inflammation of the lining of the esophagus, this is why when a pill gets stuck in the esophagus and does not go down within 12-24 hours at the most we try to remove it. The reason is that many pills can cause inflammation of the lining of the esophagus because of their composition. This is not true for all pills but some them certainly can cause worsening of the situation. Now as to whether it can cause this 5 days later, it is certainly possible as sometimes the inflammation takes time to settle down.

2) Regarding thrush in the esophagus, if you had it in the esophagus it would not come back up into the throat as you said but rather, it would cause severe symptoms in the esophagus. This would include persistent pain while swallowing which would be present for both liquids and solids and the pain would not have improved at all. Additionally, esophageal thrush/candidiasis would NOT have improved after just two days of Diflucan, it usually takes a course of the anti fungal for a week or more.

3) NO hiatal hernia does not come out of the blue but it rather develops slowly over time. This means that you would have always had a small hiatal hernia which CAN be missed on chest xrays and this event would have triggered worsening of the hernia. Most patients with hiatal hernias never know that they have had this problem because of its small size and minimal symptoms, it is usually diagnosed as an incidental finding on a chest x-ray (if it is large enough) or during an endoscopy being done for another purpose. In your case, the stuck pills could have caused inflammation of the lining which in turn could have triggered worsening of a POSSIBLE hernia OR the stuck pills, infection etc which led to inflammation of the lining exposed you to develop an H.pyroli infection. The H.pyroli infection would explain the excessive burping right now and that is why I think it would be worthwhile getting tested for it with a stool for antigen or urea breath test IF the burping does not settle down in the next week.

So in short, I think the best thing to do right now is to observe the symptoms for the next week or so, I think the excessive burping should settle down and IF it does not then we can consider testing for an H,pyroli infection. A hiatal hernia is possible but I would keep it down the list as there are other more likely possibilities to consider first. Also, an endoscopy is not necessary at this point in time, if the symptoms persist or if you again develop severe pain while swallowing ONLY then would I consider an endoscopy.

Does this answer your questions? If not let me know and we can discuss this further.

Do you have any more questions?

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Customer: replied 10 months ago.
You are so helpful.So how do they treat h pylori?You think it could be that or it could be the inflammation, or I annoyed a small hiatal hernia,which may settle down?You are saying if I had thrush in my esophagus it would not have clear up so quickly in the back of my throat?

H.pyroli is treated with simple course of antibiotics for a period of 10-14 days

I think it is likely the residual inflammation at this point in time, there is no reason to think of an infection by H.pyroli or a hiatal hernia JUST YET. I would go to those possibilities if the symptoms persist for more than a week.

Yes if you had thrush in your esophagus it usually would not clear up so quickly, the throat may have shown some improvement BUT MORE IMPORTANTLY, you would STILL have SEVERE pain while swallowing. We judge improvement of esophageal thrush on the basis of improvement of symptoms and symptoms of esophageal infections usually dont clear up within two days.

Customer: replied 10 months ago.
sorry so if the large group of pill got stuck last Tuesday/Wednesday, and then Thursday and Friday the burping started and then pain when swallowing, then they found thrush on Thursday, and the burping is still there just after eating now mainly but the pain when swelling is gone, I should not worry unless the pain when swallowing or sore throat comes back, about the thrush. And if how many more days from now should I be concerned about h pylori if I keep burping? it has been 6 days since the pills got stuck and I read thrush also causes heartburn, so could it would from that too?

Yes that is correct, you should worry unless the pain while swallowing comes back OR if you develop severe sore throat once again.

Also i would wait a week from today before i start thinking about h.pyroli etc. I would start counting from now rather than when the pills got stuck because the inflammation would have started at that point and then the thrush developed, so it will take some time for the inflammation to go down. The heartburn is also because of inflammation and stomach acid coming back up (reflux which we talked about previously) and that can be because of the thrush or even the pills themselves. Again that should settle down in a week or so.

Customer: replied 10 months ago.
Ok, I will do that, thanks again so much, you really take your time to give detailed responses and I appreciate it!!

You're more than welcome and i hope you DO feel better soon. Best of luck!!, do remember to leave a POSITIVE rating by clicking on the stars above your screen as that is how we are compensated for helping you today. Any BONUSES would be well appreciated!

Dr. Muneeb Ali, Intensivist
Category: Endocrinology
Satisfied Customers: 11880
Experience: Have experience of Endocrinology over the last 3 years
Dr. Muneeb Ali and other Endocrinology Specialists are ready to help you
Customer: replied 10 months ago.
Can I ask you an unrelated ? I woke with gas and burping last night, thrush is all gone had drank and ensure and ate ice-cream because I am trying to gain weight, I have the gas and pain up in my chest and throughout stomach, and it has lessoned today. Is this a symptom of a heart issue? Burping, excess gas?

That is NOT a heart issue but rather it is indicative of a stomach issue, acid coming back up into the chest. OTC prilosec would be helpful in this situation.

Customer: replied 10 months ago.
are you online for me to ask a new question?

Hello,

I just came back online

Customer: replied 10 months ago.
r u online now?

Yes i am, please ask your question in a new thread

Customer: replied 10 months ago.
Ok, I willpost for you. Thanks!

You are welcome.

Customer: replied 10 months ago.
I sent you a question under endo and asked for you only.
Customer: replied 10 months ago.
Did you find the ??

Yes i answered it over there, please check there now.

Customer: replied 10 months ago.
are you online if. post a ??

I am online now