Chronic Urticaria + Esophageal Stricture?

Hello, I am new to the community, and hoping to get a few opinions from people who might have an experience similar to mine.

I am a 25 year old female who has suffered from what was originally diagnosed as pressure urticaria by my primary physician, about five years ago. At the time, I was breaking out in massive plaques of hives, especially where my bra straps/underwear pressed on my skin as well as on the pads of my feet and hands. They seemed particularly affected by heat/lots of physical activity. Antihistamines seemed to work just fine at controlling them, and I have been taking Zyrtec almost daily ever since.

In the meantime, things have gotten a little stranger. I have had children since my urticaria was diagnosed, and this seems to have changed the ballgame entirely. My hives can manifest as an internal pain, where my joints and muscles ache and sometimes swell, especially in my hands, wrists, and pads of feet (almost a carpal tunnel-like tenderness). This is especially true when I have been walking/running, or working with my hands, for an extended period of time. I've also started keeping a food diary as certain foods/drinks have been noted to set off my reactions - particularly red wine, beer, and certain types of bread. I have been repeatedly discouraged by my physician in pursuing an allergy panel, for, according to him, 80% of urticaria causes are never discovered. He did give me an 8-day course of Prednisone, to attempt to knock my histamines back into shape, though I didn't really notice a big difference after a few weeks.

I guess I am not being assertive enough with him; I know I need to see an allergist. On the to-do list, like everything else.

At any rate, I still take Zyrtec daily, and this seems to keep the majority of the obviously urticaria-related symptoms at bay. I've sort of adjusted to just living with it.

THEN...

Five months ago, I had an attack of what I thought was GERD, which I had never experienced before. It literally felt like I had a wedge of food stuck behind my breastbone; I thought I wasn't chewing my food enough. My esophagus feels like it is constricting, in waves, sometimes so intense I actually gag and vomit up foam (not acidic at all, as if it does not come up from my stomach). These episodes last 24-48 hours, where any sort of solid food only exacerbates the situation, and I can't sleep or do much of anything else. I have an incredibly hard time swallowing. There is no heartburn/acidic burning to accompany these attacks, though I do burp often (they just seem like "air" though, no foul taste or odor). I've only experienced these episodes 3-4 times in five months, however, the one I suffered this weekend was so thoroughly intense I wound up going to urgent care and getting a steroid injection to calm it down (absolutely helped, until I ate something solid the next day, and it started all over again). Ingesting Prilosec, Zantac, nor apple cider vinegar doesn't seem to do anything for me, thus my doubts that it is acid reflux-related.

I can't pinpoint a trigger. I had a Quizno's sandwich over 24 hours before the attack started and all I can think is that the wheat bread did something!?

Honestly, this entire experience has me exhausted. I have never had a food allergy in my life before I turned 20; I am a fairly healthy person with no other conditions. Does ANY of this sound familiar to ANYONE?

I am particularly interested in whether anyone has suffered complications with esophageal stricture in relation to their urticaria. Please share your story!

Thank you, thank you, in advance, and namaste.

Hi Alcie, thank you for the warm welcome and such useful information!

After staying up all night Saturday with these esophageal "strangulations," I got well-acquainted with some of your postings regarding sulfite intolerance/sensitivity and how they relate to GERD...some of it sounded all too familiar. Thus, Sunday, I stayed away from anything with sulfite in the label, didn't eat any breads/baked goods/anything containing eggs, and drank only water. I pretty much stuck to raw fruits and vegetables. No reactions! I was very encouraged by this, and plan on modifying my eating habits accordingly, at least until I can get some labwork done and see a specialist or two. I did eat ground beef yesterday for early dinner and it didn't seem to bother me. It really seems like the breads and red wine/wheat beer are what do me in.

I'm sure there's an organic/specialty bakery around me somewhere, being in Southern California where everyone is so health conscious now! I'll have to do some research.

I managed to get an appointment with my physician this morning and I have a slew of questions written down for him pertaining to some of the information I have already found here. Hopefully he'll get me pointed in the right direction for treatment. I feel much better informed having read yours and others' posts - I'd never even heard of sulfite intolerance before yesterday.

Thanks again! And I'll be sure to report back with any findings.

Good morning...the reason I'm posting this reply is because I'm suffering from the same symptoms described above, but my CBC or FBC didn't show any , even slightest rise, in eosinophils, everything else seems normal, even the hepatitis markers...the Wedge behind sternum is a very accurate descript ion to the pain... I'm starting to wonder :is it C1 Esterase inhibitor insufficiency? if there are any differential diagnoses to such case, I'll be eternally grateful Post Edited (Resident) : 3/14/2013 9:31:13 PM (GMT-6)

Hi olivehead,
Did you ever get a diagnosis of your condition. I have had very similar symptoms which are chronic urticaria and painful stomach cramps which seem to go from the lower oesophageal sphincter up the oesophagus and even to my throat. When it gets really bad it is very sharp and also goes across my stomach and even seemingly up my backbone. I have noticed that my positioning can sooth or exacerbate the pain, such as sitting down leaning forward can bring it on and lying down in a certain position can sooth it, but the position isn't always the same. I have been diagnosed with unspecified autoimmune disease or idiopathic urticaria, but my immunologist, gastroenterlogist and GP all say that the pain is gastritis and not connected my urticaria, but I am not convinced, because they always manifest together and it doesn't explain my difficulties in swallowing, the food getting momentarily caught in my esophagus. Anyway, if you're still around let me know.
Cheers

Welcome, DanteD.

Poppie has it right. Get started on the food journal/diary/log. To make it more confusing it can be only a part of the egg. I react to the yolk, my favorite part. (sulfur)

It takes a couple of months, maybe more, but it's the only way to find your own food intolerances that don't show up on the regular allergy tests. Intolerances/sensitivities are not the same as allergies. They don't necessarily cause histamine release. If you do a good bit of reading in the archives (search box at the top of the page) you'll find dozens of posts with all sorts of information, maybe even some exactly like yours.

Your pain may be due to several things, not necessarily what you think it is. Heart and stomach pain can mimic each other. The transverse loop of the large intestine is also right under the stomach and can be confusing when there's a bit of gas. Liver and gallbladder and kidney or pancreas can seem like stomach problems.

Trouble swallowing may not have anything to do with a food sensitivity. Mine was caused by a virus - polio. There are plenty of other things too that can affect the swallowing, like a weak LES (lower esophageal sphincter).

All those big organs, colon and small intestine too, are connected by the vagus nerve, so when there's a problem with one another may react. I get tachycardia when I have a reaction to a food trigger. I have also had tachycardia and vomiting when I've had an inflamed diverticulum in the sigmoid colon or the acending colon. These reactions can come on well before there is any pain! My reaction is called "linked angina" or "cardioesophageal reflex."


Some people react to things like sulfites with urticaria. Some with headaches. I get nausea and tachycardia. Just to make it more confusing. That's why you really do have to keep a good record - to be able to link your reaction to a food or chemical - if indeed there is a link.

I don't want everyone to jump on the sulfite bandwagon. You could have a problem with salicylates or MSG or .... ?

Just get your list, then try to break down meals into ingredients. Look up the items with the keywords food allergies or food sensitivities, and you may come up with the solution.

Most doctors don't get it. But there are scientific papers. Don't trust blogs or forums, even this one. We're not doctors and mostly not scientists!

You can find Housemouse's story of skin problems in the "links" section of www.learningtarget.com/nosulfites/index.htm

Best wishes and keep in touch.

Sounds like parasite or dental to me-could be both. Have you had anyone check into parasite-dental.
I once met the guy who got written up as The Real Dr. House-he told me 25 % of his cases he cured were parasites-he sent everyone to the lab.(FYI most of the people he saw had alredy seen 15-20 docs) Problem is most labs aren't good at testing. I havnt spoken to him in years but I got to wonder if he just should treat parasites for two weeks no matter what

Post Edited (magoo2) : 5/11/2015 5:25:15 AM (GMT-6)

I am new to this forum, I was diagnosed with urticarial May 2014 after presents of hives and one bout of a sever esophageal spasm. In July 2014 along with hives controlled by doxopine I started having esophageal spasms. Getting stronger through the fall I went to the Mayo in Rochester, MN were the gasto doctors used me for a dart board. Nothing worked, my bouts were very similar to Oliveheads, only mine came less than a week apart and lasted 12 to 48 hours. Same as Olivehead, unable to swallow even my own saliva with retching of foam and non stomach fluids. Finally got a dart to stick, on a whim Dr prescribed Budesonide gel (a steroid), swallow 10ml twice per day and don't eat or drink anything for 2 hours. I'm trying to cut back, but going once per day has brought back light spasms. Just wondering if anyone else has had similar results and if there are foods to avoid that may help?

Sorry to bump this topic, but my post may help others.

I had Pressure Urticaria all over including lower esophageal sphincter ("LES") pain that was caused by upward pressure from the stomach due to overeating and/or bloating. Also caused when lying down at night when bloated/full which also increased the pressure on the LES. I understand that the swelling obstructed the natural muscle contractions of the esophagus at the LES causing strong radiating pain when swallowing.

Two suggestions that work for me:

1. Address the underlying cause - which in my case was undiagnosed constant sinus infections over many years - which caused my immune system to go haywire leading to pressure urticaria - I treated the sinus issue with surgery and the urticaria was 99% gone.

2. Avoid overeating, particularly in the evening, and keep track of any foods that may cause bloating - this will help reduce pressure on the LES.

Otherwise, Zyrtec helped to keep symptoms in check (most of the time).

Dear Olivehead,
I deeply sympathize with your situation and hope you are finding answers to your problem. I have had allergies since getting hives from formula as an infant, but have recently developed a new one which has the symptoms you describe - the feeling of a stone lodged in the esophagus followed by copious amounts of foamy saliva being produced, without digestive juices taste, and which erupts as it fills up the esophagus. After keeping a food diary I now know it is a reaction to meta-bisulfites, labeled as sulfites. Mine started with Maine Roots Ginger Beer, which I drank regularly for about six weeks with no problems. The ginger beer was not labeled as having sulfites, but after a month or so of not having the ginger beer I was out to dinner with friends and noticed a different brand of ginger beer and ordered it. By the time the food came, having drunk about half a bottle of the ginger beer, the very first bite lodged in my esophagus and caused the symptoms you described, which were both uncomfortable and embarrassing. As I couldn't eat my dinner, I took it home with the remainder of the ginger beer, which is when I noticed that there were sulfites in it. I was able to eat the food the next day, but had the reaction again as soon as I had even a sip of the ginger beer. The next time it happened was after a small wedding where we drank sparkling wine from Italy and again, by the time the food came the very first bite lodged in my esophagus and caused the same symptoms. After two reactions to sulfites, I emailed the Maine Roots company and asked if there was any chance the ginger had been exposed to sulfites before it reached them and received a one word answer "No". Not long after, I was out to dinner with a friend who ordered a Maine Roots Ginger Beer and asked if I wanted a sip. I accepted, believing it was safe, and had the same reaction after the first bite of food. Again I took the food home with me, and as before had no reaction to the food. I asked a Physician friend if this made any sense to him, and he said it was exactly like my experience with an antibiotic which I took for 6 weeks as treatment for Lymes Disease but more than a year later, got hives from it. This is how allergies develop in people who are prone to getting allergies, he said. I've never had GERD or any of the other conditions which cause esophageal strictures, but now must be very careful when eating to take small bites and chew very thoroughly or I will have the reaction without ingesting sulfites. This is complicated by the inconsistent labeling laws for sulfites, which I learned looking at the Mayo Clinic and other websites. Many canned or frozen fruits, vegetables or even spices which would naturally oxidize or brown are allowed to be treated with sulfites without being labeled. I now buy only organic spices for this reason. Good luck with your journey and hope you are finding answers. Best regards, Fallgirl.

Olivehead-can you tell me what you have found out. What you described is exactly what I've been going through. Chronic huge hives all over, joint pain in my wrists and feet, feeling of something stuck in my throats that comes and goes, foamy in my throat, been to every doc and have had every test done. My eosinophils are through the roof elevated. Any medication that helps or anything you found out?