Dr. Navajith A. Mani
General Practitioner
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Patient's Query
Hi doctor,
I have stomach upset symptoms and also suffering from depression or anxiety, trouble of movement, dizziness, high blood pressure, fatigue, nausea, loss of sensation, tightness of the chest and some time feel pain, loss of concentration and body movement, vertigo include a sense of spinning, loss of balance, whirling, with low constant fever. When I take Alprazolam, I feel relaxed, but after 16 hours, I have to take it again for relaxation. I am also a smoker. I tried to stop smoking, but strong cravings forced me again to do smoke. I am so much worried. Kindly help me in this regard to how I can protect myself from this bad habit; if any medicine that will help reduce nicotine level from blood, kindly advise how I can successfully stop smoking. Before one year, this medical issue was happened due to a rise of BP 170/110, but now it reaches 160/100 and some times 140/90 or sometimes it is normal around 130/80 when I take the dose of Alprazolam. I am taking Alprazolam (ALP) 0.25 mg, Inderal 10 mg in case of high blood pressure or pulse rate, and for stomach Esomeprazole 40 mg.
Recently I have done blood tests, but some results make me worry mentioned below:
Complete Blood Count
1) Platelet count result (126) unit (x10^9/I) normal range (150.00 - 400.00).
2) Neutrophils result (22) unit (%) normal range (40.00 - 75.00).
3) Lymphocytes result (68) unit (%) normal range (20.00 - 45.00).
Serology Report
1) Anti H. pylori antibodies result (positive).
Liver Function Tests
1) SGOT (AST) result (46) unit (U/L) normal range (10.00 - 40.00).
Lipid Profile
2) LDL (cholesterol) result (67) normal range (100.00 - 130.00).
Kindly give your opinion.
Hello,
Welcome to icliniq.com.
You have GERD (gastroesophageal reflux disease), antral gastritis (with helicobacter pylori infection), with early-onset hypertension, depression, and anxiety disorder. GERD is a common clinical problem, affecting millions of people worldwide. Acid suppressive therapy provides symptomatic relief and prevents complications. If no alarm symptoms are present on upper GI (gastrointestinal) endoscopy, initial management of GERD should be geared toward lifestyle modification.
Lifestyle changes remain first-line in management of GERD with a primary goal of symptom reduction and improvement in quality of life. Lifestyle modification for the management of GERD is head of bed (HOB) elevation, shown to decrease esophageal acid exposure and esophageal clearance time with subsequent reduction in symptoms in patients with supine GERD.
You should be on more medication.
1) For early-onset hypertension, get an ultrasound abdomen pelvis to assess kidney (to assess cortico-pelvis differentiation, renal size) and start medication accordingly.
2) For anxiety disorder, I suggest you take Clonazepam 0.5 mg as and when needed.
3) For GERD and antral gastritis, I suggest you take, Levosulpiride (75 mg) with Pantoprazole (40 mg), Sucralfate (500 mg or 5 ml) with Oxetacaine (10 mg or 5ml) containing syrup. Get upper GI endoscopy.
4. CBT (cognitive behavior therapy) for anxiety disorder.
I hope this was helpful.
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General Practitioner
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