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Suggest Treatment For IBD

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Posted on Thu, 25 Feb 2016
Question: I need help with a possible diagnosis or what testing I should have done. I have been sick on and off since 2006 while in.the military but after getting back from haiti in 2011 and being diagnosed with ebv ive never really felt normal again. due to all my symptoms they did an occult test which was positive, in which they did 3 colonoscopys and 3 endoscopys, plus mris, xrays, esophageal manotomy, etc etc. They found ulcers the first time, blood and colitis second one so the dr. thought it was ibd. My new dr just did another colonoscopy, said she found nothing and its not ibd. i now have no diagnosis Years later.
doctor
Answered by Dr. T Chandrakant (38 hours later)
Brief Answer:
Please give details as requested below

Detailed Answer:
Hi.
Thanks for your query and the clear images.
To recapitulate: Female/32 - Sick on and off since 2006 while in the Military - not felt normal again after returning from Haiti in 2011 - diagnosed as EBV - did all the tests - found ulcers the first time - some Doctor thought about IBD - new one says normal - no diagnosis for years...
I had a chance to read your other queries and which says you have 900 pages of records - this means you must have been tested and treated by various Doctors.

Well, the pictures you have posted about ulcers in the lip, tongue, palmar erythema and skin lesions indicate that you have been suffering from some sort of allergic reaction.
Since our Medical dictum says: anything under the sun including the sun can cause allergy, it is solely you, who can point out the instigating or enhancing factors.
- Please give me some additions information for me to assist you further:
Please give the symptoms in chronology, meaning since the first day how it started and what were the symptoms in the initial periods and how the things continued or grew.. A very good clinical history can give 90% of the diagnosis, the tests are there to support the clinical diagnosis.
- Make a list of the foods, beverages, and other factors of day-to-day which can instigate or enhance your problems. Please take all the time to make a proper list on paper or your computer. try to memorize everything possible and we may get a clue to start with.
- Make the similar list, but this to say which does not cause any problems, suits you.
- List of medicines and any other things that helped/helps you.

I know this is tedious, but will helps us both. Please take all the time you have as this is very important.

Once I get the feedback, we can discuss further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (5 hours later)
i have attached my answer since the program wont let me type it in. also some newer labs.
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
Details noted, investigations advised.

Detailed Answer:
Thanks for your feedback. Read the history well.
Bloating and distension of stomach 80 per cent of times.
Drastic weight gain.
Fecal test positive for blood in 2011.
Diet change did not help
Taking Asacol. vitamins, probiotic and kolonopin.
Cipro helped a lot as as also charcoal
Frequent illness in childhood.
Pimples/impetigo on face.
Could have ulcers but parents did not follow up.
Joined army - started as Itchy eyes, rashes that last for weeks, bronchitis, joint pains , was told degenerative arthritis, narrowed discs, stress fractures hips.
Moved to *South XXXXXXX - no symptoms for 7 months. Restarted the problem as stomach ache - constipation for 10 days - severely fatigued.
Came back to USA and everything was alright until came back from Haiti - started as face rash, fatigued, could not keep eyes open - they thought about depression which you not feel so - EBV positive - had to leave school and anxiety - started meds ...
This is all you could post. even not the other reports.

All the history was important and you did put in nicely.
The most important points were:
Cipro helped a lot. This is an antibiotic and possibly treated the intestinal problems well as it is active against intestinal infection.
Joined army - started as Itchy eyes, rashes that last for weeks, bronchitis, joint pains. This too indicates a part of the symptom complex and may be related to the intestinal problems.

I would advise you the following:
- Please discus all these points together with your treating Doctor and get the following investigations:
- stool tests for 3 consecutive days.
- blood culture and sensitivity
- A course of Cipro again, you need a prescription.
- CT scan of the abdomen.
- Enteroclysis for small intestines under a fluoroscopy.

These tests will give specific diagnosis and a chance to have a plan for curative treatment.

I hope this answer helps you.
Please give feedback.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (35 minutes later)
fecal test was positive in 2015, which lead to them doing another colonoscopy. first one they found ulcers (2013), second one they found colitis (2015), third one they found nothing, biospy showed nothing (2016). already had the stool testing for both XXXXXXX and foreign bacteria...as well as cdiff, etc. asked my dr today for cipro and she said no. already had 2 ct's done, also mri recently (dec 2015) nothing showed up except gallstones but mr dr has seen me 3 times since and not even mentioned them (or told me i had them, read it in my results) so i figured they are not a problem. i will ask about the enteroclysis being done as i have never had that. as far as blood, i have all my results....as the drs have really tested me for evetything but cant seem to get a diagnosis, should i inclyfe those for you to view or could you please instruct me on what i should ask my drs to test for?
doctor
Answered by Dr. T Chandrakant (6 hours later)
Brief Answer:
As explained below.

Detailed Answer:
I think gallstones can be the reason for some of the gastrointestinal symptoms.
Hence removal of the gall bladder may help you.

Blood in stool can come positive even if it is coming from anywhere from nasal and oral cavity, esophagus, stomach small and large intestine, Hence only colonoscopy may not be sufficient to detect the cause.
Since you have traveled so much, have you taken medicines for intestinal worms.Please ask for the prescription or ask the Pharmacy and take it if it is an OTC in your country.

Enteroclysis reports awaited.
You may post the stool reports only. I think you have to delete the previously posted images to get sufficient space for new postings.

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19777 Questions

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Suggest Treatment For IBD

Brief Answer: Please give details as requested below Detailed Answer: Hi. Thanks for your query and the clear images. To recapitulate: Female/32 - Sick on and off since 2006 while in the Military - not felt normal again after returning from Haiti in 2011 - diagnosed as EBV - did all the tests - found ulcers the first time - some Doctor thought about IBD - new one says normal - no diagnosis for years... I had a chance to read your other queries and which says you have 900 pages of records - this means you must have been tested and treated by various Doctors. Well, the pictures you have posted about ulcers in the lip, tongue, palmar erythema and skin lesions indicate that you have been suffering from some sort of allergic reaction. Since our Medical dictum says: anything under the sun including the sun can cause allergy, it is solely you, who can point out the instigating or enhancing factors. - Please give me some additions information for me to assist you further: Please give the symptoms in chronology, meaning since the first day how it started and what were the symptoms in the initial periods and how the things continued or grew.. A very good clinical history can give 90% of the diagnosis, the tests are there to support the clinical diagnosis. - Make a list of the foods, beverages, and other factors of day-to-day which can instigate or enhance your problems. Please take all the time to make a proper list on paper or your computer. try to memorize everything possible and we may get a clue to start with. - Make the similar list, but this to say which does not cause any problems, suits you. - List of medicines and any other things that helped/helps you. I know this is tedious, but will helps us both. Please take all the time you have as this is very important. Once I get the feedback, we can discuss further.