Struggling with Persistent Head Pressure: Which Specialist to Consult?

Unsure which specialty to consult?

Hello Doctor, my symptoms started with headaches.
Then, since August of the year before last, I began experiencing belching and nausea, but I couldn't vomit.
My head feels very heavy, and I have difficulty concentrating.
I have been intermittently taking medication since August of the year before last, and while my gastroesophageal reflux has improved, the head issues have not resolved.
The medication hasn't helped, and whenever I eat something oily, I feel discomfort throughout my body.
I experience body aches and need to drink 1400cc of water or vinegar water to feel better; otherwise, my head feels dizzy.
Since August, after getting up and having a bowel movement, I feel pressure in my head.
If I don't eat, there is no pressure, but as soon as I eat, I feel pressure in my head and need to drink 1400cc of water to alleviate it.

I have been careful not to eat too much oily food, and I have noticed that if I go too long without eating, I don't feel hungry.
I have undergone gastroscopy, colonoscopy, and ultrasound examinations at Tainan Hsin-Lou Hospital, but the cause remains undetermined.
I have had sinusitis for 15 years, but the doctor said I do not need surgery.
My left nostril has been dry since August, and I have hard nasal mucus, with my nasal hair becoming coarser.
An ENT specialist said I have an infection and prescribed medication and topical treatments, but the infections keep recurring.
I do not have a habit of picking my nose.
Doctor, what should I do?
P.S.
I have also sent my information to the hepatobiliary and gastroenterology department.

Huang, 20~29 year old female. Ask Date: 2008/05/26

Dr. Chen Yuchao reply Family Medicine

If you have various symptoms, please visit a family medicine clinic.
The family medicine physician will take a detailed medical history and refer you to the appropriate specialty for further evaluation.

Reply Date: 2008/05/26

More Info

Hello! It sounds like you are experiencing a complex set of symptoms that have been affecting your quality of life for quite some time. Based on your description, it seems that you have persistent head pressure, nausea, and other gastrointestinal issues, which may be interconnected. Given the range of symptoms you are experiencing, it would be advisable to consult with multiple specialists to get a comprehensive evaluation.

First and foremost, since you are experiencing persistent head pressure and difficulty concentrating, a neurologist would be a crucial specialist to consult. Neurologists specialize in disorders of the nervous system, including headaches, migraines, and other neurological conditions. They can perform a thorough neurological examination and may recommend imaging studies, such as an MRI or CT scan, to rule out any structural issues in the brain that could be contributing to your symptoms.

Additionally, your history of sinusitis and nasal issues suggests that an otolaryngologist (ear, nose, and throat specialist) should also be involved in your care. Chronic sinusitis can lead to pressure in the head and may contribute to feelings of heaviness or discomfort. The ENT specialist can evaluate your nasal passages and sinuses for any signs of infection or obstruction that may require treatment.

Moreover, since you mentioned gastrointestinal symptoms, including acid reflux and discomfort after eating, consulting a gastroenterologist is also advisable. They can assess your digestive health and determine if there are any underlying conditions, such as gastritis or food intolerances, that could be exacerbating your symptoms. It’s important to address any gastrointestinal issues, as they can significantly impact your overall well-being and may be linked to your head pressure.

In terms of managing your symptoms, it may be beneficial to keep a detailed diary of your symptoms, including when they occur, their severity, and any potential triggers (such as certain foods or activities). This information can be invaluable for your healthcare providers in diagnosing and treating your condition.

You mentioned that you have been taking medications, but they have not provided significant relief. It’s essential to communicate this with your doctors, as they may need to adjust your treatment plan or explore alternative therapies. Sometimes, a multidisciplinary approach that includes physical therapy, cognitive behavioral therapy, or dietary modifications can also be beneficial.

Lastly, consider lifestyle factors that may be contributing to your symptoms. Stress management techniques, such as mindfulness, yoga, or relaxation exercises, can help alleviate tension and improve your overall mental health. Staying hydrated, as you mentioned, is also crucial, as dehydration can exacerbate headaches and feelings of fatigue.

In summary, I recommend consulting with a neurologist, an otolaryngologist, and a gastroenterologist to address the multifaceted nature of your symptoms. A comprehensive approach that considers all aspects of your health will be essential in finding effective treatment and improving your quality of life. Don’t hesitate to advocate for yourself and seek the care you need to feel better.

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