Does caffeine cause my persistent nausea and anxiety?

Question

Hi doctor,

I have had persistent nausea for roughly 15 months now. I remember it began on a holiday when I had drunk coffee and ended up with anxiety symptoms.

I have had many tests done, and an endoscopy found eosinophilic esophagitis (basically, esophagitis caused by an allergy). I have been treated with a PPI, which appears not to be helping, and have also been prescribed Lovan (Fluoxetine). I am currently one week into taking these tablets and have recently cut out gluten and dairy to see if the allergy was from these foods.

The doctor did a RAST test, which showed a class 0 allergy to all main food groups, including wheat and milk. So I have just started eating them again. I have just drunk my first coffee in about a week and had severe panic symptoms and a tight throat, which I have never experienced before. I would like to know if a caffeine allergy is likely and if it could be the cause of all these problems. I used to drink coffee fairly regularly and never quite felt great off it, but it never seemed to worsen the nausea.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

After going through your history, it is very clear that what you described are two totally different issues. One thing is eosinophilic esophagitis (an allergic inflammatory condition of the esophagus that involves eosinophils), and the second is caffeine sensitivity. I used the word "sensitivity" for caffeine because it is different from caffeine allergy.

What you are suffering from now may be caffeine hypersensitivity, as there are no other allergic symptoms associated with panic attacks. Even if you were having coffee before, you may become hypersensitive to coffee now.

The treatment for it is to avoid coffee and see the difference. Some oral steroid sprays like Flovent (fluoxetine) are also advised by gastroenterologists to prevent the side effects of long-term oral steroids. It is very difficult to differentiate between caffeine sensitivity and allergy based on clinical examination. For that, you need to do a skin prick test. Finally, avoidance is the best strategy for treating caffeine sensitivity.

Please let me know if you want more help.

Thank you.