Hello,
Thank you for asking your query at DoctorSpring.
One striking feature in you medical history is the relationship with alcohol and the symptoms. So we can safely assume that your symptoms are due to alcohol related gastritis and more of an esophagitis. A negative H.Pylori is expected as this is more like an irritant damage than because of an acid peptic disease caused by bacteria.
Regarding your localisation to epiglottis, well I do agree the pain might be more pronounced in the upper throat, but if you look at the etiopathology (the alcohol related damage) the damage should be there throughout the oesophagus and stomach. It’s just that you feel the discomfort more the in the epiglottis. Moreover being a medical personal you would be well aware that visceral pain is poorly localised. Being said that there could be considerable damage in the outer surface of the epiglottis (which might aggravate by the voice induced damage). But there is less chance the singing per se caused much damage, as the pressure build up and friction affects the larynx and vocal cord mostly. No other bacteria other than H.Pylori can cause similar symptoms. The foul smell seems unrelated and need investigation only if the symptoms persist further.
The right approach would be to –
1. Continue Omeprazole 20mg once daily just before sleep (that is at least 1hour interval with food) – 14 days
2. Syrup Sucralfate 1 tsp at least half an hour before food thrice a day. Sucralfate forms a protective coating and helps in healing. This is a prescription drug in certain countries, in that case get in touch with your Doctor.
3. Strictly avoid alcohol, spices and irritant food items. Take meals are regular intervals.
4. An Upper GI endoscopy – This will help in assessing the damage and also rare caused like pharyngeal pouch abscess can be ruled out (which can caused foul smell)
Hope this helps. Please take care not to consume alcohol in immediate future.
Please feel free to ask followup queries.
Thank you
Patient replied :
Hello, I appreciate your quick response. I'm going to recommend the upper GI endoscopy. It's going to be tough to get the military to go through with it because last time I was told they need to see a "strong indication" that it is necessary. I will push for it. I guess what I dont fully understand is the healing rate of the mucosa that were damaged. I mean...i have stopped drinking since really about over a year ago and ive been on omeprazole for 6 months. I dont do spicy foods and i try to drink water. I this something that heals on it's own extremely slowly? Hopefully this damage won't last forever seeing as I'm very healthy.
Thank you again for your time,
Jacob
Hello Jacob,
Since you said “I recently went to military training in Texas and tested my limits with the drinking,…” I just assumed it was very recent. If it is isolated Alcohol Gastritis/Esophagitis with damaged only to mucosa the healing should occur in weeks. If there is an ulcer the healing can be delayed and might take months to completely heal. More over your symptoms are not very typical. Esophagitis can occur, but predominant symptom will be gastritis (stomach pain). So I guess the best logical step would be an Endoscopy. I feel you do have strong indication for that. Please discuss this with your Doctor. Even an isolated episode of vomiting up of small quantity blood can occur in this condition (which is a strong indication for scopy).
Hope this helps.
Thank you.