Tinnitus and Digestive Issues: When to Seek Help

Tinnitus, gastrointestinal discomfort, and other related issues?

Hello, about a month and a half ago, I experienced headaches and was diagnosed with tension-type headaches (muscle tightness) after a consultation.
The frequency and intensity of the headaches have since decreased.
However, shortly after the headaches began, I started experiencing a high-pitched tinnitus in my left ear, which affects my sleep.
I visited two ENT clinics, and both said there didn't appear to be any issues with my ear, and my hearing tests were normal.
One clinic suggested that it might be caused by nasal allergies and prescribed medication for that, but the tinnitus has not improved (it has persisted for almost a month).

Then, about two weeks later, my stomach suddenly became very uncomfortable.
I feel nauseous after eating, and sometimes I even feel cold and a bit dizzy.
I consulted a gastroenterologist who prescribed some stomach medication.
After three or four days, the nausea decreased, but I still feel somewhat uncomfortable and occasionally experience chills and dizziness.
Given that I have multiple symptoms, I'm unsure which specialty I should consult next.
I apologize for the trouble, and I appreciate your help in answering this!

K, 20~29 year old female. Ask Date: 2017/01/25

Dr. Chen Taicheng reply Family Medicine

● There are many causes of tinnitus, and the most important step is to rule out the possibility of hearing loss or impairment, such as Meniere's disease (which often presents with vertigo, hearing loss, and tinnitus) or sudden sensorineural hearing loss (which may also be accompanied by tinnitus).
Most tinnitus is subjective (the sound of tinnitus can only be perceived by the individual), and potential causes include outer ear conditions (such as earwax impaction or otitis externa), middle ear conditions (such as tympanic membrane perforation or otitis media with effusion), inner ear conditions (such as Meniere's disease or ototoxic medications like certain antibiotics and nonsteroidal anti-inflammatory drugs), and issues with the auditory nerve pathways.
● Tinnitus can also occur simultaneously with headaches, most commonly associated with migraines; however, it can coexist with other types of headaches as well.
● It is recommended to visit an otolaryngology department in a hospital to determine any issues related to the outer, middle, or inner ear.
If tinnitus is still associated with headaches, please seek further evaluation from a neurologist.
Tinnitus can be a bothersome symptom, and there are medications and various non-pharmacological therapies available that may help improve it (though they may not necessarily cure it).
● Gastrointestinal issues, such as dyspepsia or gastritis, generally improve gradually; if discomfort persists, please consult a gastroenterology department.
Tinnitus or other discomforts (including dizziness) may also lead to gastrointestinal issues, so it is advisable to first seek evaluation for tinnitus, dizziness, and headache concerns.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital's Family Medicine Department cares about you.

Reply Date: 2017/01/25

More Info

Hello! It sounds like you’re experiencing a complex set of symptoms that are affecting both your auditory and digestive systems. Let's break down your situation and discuss when it might be appropriate to seek further medical help.

Tinnitus and Its Possible Causes
Tinnitus, which is the perception of noise or ringing in the ears, can be caused by a variety of factors. In your case, it seems to have developed after experiencing tension headaches. Tension headaches can lead to muscle tightness in the neck and jaw, which may contribute to ear-related issues, including tinnitus. Additionally, you mentioned that you have been experiencing some nasal allergies, which can also lead to Eustachian tube dysfunction, causing pressure changes in the ear and potentially resulting in tinnitus.

You’ve already consulted two ENT specialists, and they found no significant issues with your ears. This is a positive sign, as it suggests that there may not be a serious underlying condition affecting your hearing. However, since your tinnitus has persisted for almost a month, it may be worthwhile to consider other potential causes, such as:
1. Stress and Anxiety: These can exacerbate tinnitus and may also contribute to your tension headaches.

2. Medication Side Effects: Some medications can cause or worsen tinnitus. If you are taking any new medications, it’s worth discussing this with your doctor.

3. Neurological Factors: In rare cases, tinnitus can be linked to neurological conditions, so if your symptoms persist or worsen, further evaluation may be necessary.

Digestive Issues
Regarding your gastrointestinal symptoms, it’s common for stress and anxiety to manifest as digestive problems. The nausea, cold sensations, and dizziness you’re experiencing could be related to gastrointestinal distress, possibly exacerbated by anxiety or tension. You mentioned that you have seen a gastroenterologist and received medication, which has helped somewhat but not completely resolved your symptoms.

When to Seek Further Help
Given the complexity of your symptoms, it may be beneficial to take a multidisciplinary approach. Here are some recommendations:
1. Follow-Up with Your Primary Care Physician: They can help coordinate your care and may refer you to specialists as needed. They can also evaluate whether your symptoms might be interconnected.

2. Consider a Neurologist: Since you have experienced both headaches and tinnitus, a neurologist may be able to assess whether there is a neurological component to your symptoms.

3. Consult a Psychologist or Counselor: If stress or anxiety is a contributing factor, speaking with a mental health professional could provide strategies to manage these feelings, which may in turn alleviate some of your physical symptoms.

4. Dietary Consultation: If your digestive issues persist, a dietitian can help identify any food sensitivities or dietary changes that might improve your symptoms.

5. Allergy Testing: If nasal allergies are suspected to be contributing to your tinnitus, an allergist can perform tests to identify specific allergens and recommend appropriate treatments.

Conclusion
In summary, your symptoms of tinnitus and digestive discomfort could be interrelated, possibly influenced by stress or tension. It’s essential to continue seeking medical advice, especially if your symptoms do not improve or worsen. A comprehensive approach involving multiple specialists may provide the best chance for a thorough evaluation and effective treatment. Don’t hesitate to advocate for yourself and seek further evaluations if you feel your concerns are not being fully addressed. Your health and well-being are paramount, and it’s important to find the right support to manage these symptoms effectively.

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