
Suggest Treatment For Internal Hemorrhoids And Sluggish Colon

Test Results
Cortisol 7/31/14 8/20/14 9/29/14 10/3/14
CORTISOL MORNING
4.3 - 22.4 ug/dl
2.0 L 36.5 H 31.6 H 1.4 L
Name
Standard range
7/31/14 9/29/14
GLUCOSE, FASTING
70 - 99 mg/dL
65 L 102 H
Name
Standard range
7/31/14 9/29/14
INSULIN
3.0 - 28.0 mU/L
20.3 30.2 H
Name
Standard range
9/29/14
25-HYDROXYVITAMIN D
20 - 96 ng/mL
16 L
Name
Standard range
3/26/14 7/28/14 8/20/14 9/29/14
TSH
0.35 - 5.50 uIU/mL
2.51 0.41 2.86 3.20
Standard range
7/31/14 8/20/14 9/29/14
ACTH
6 - 50 pg/mL
5 L 52 H 6
Name
Standard range
3/26/14 9/29/14
T4 FREE
0.89 - 1.76 ng/dL
1.28 0.94
SPECIMEN VOLUME 24 HR URINE 800
ESR 0 - 20 mm/hr 12
DNA DOUBLE STRAND AB, SERUM, QUAL <=4 IU/mL <1
ESTRADIOL <11.8
SODIUM 135 - 145 mEq/L 140
POTASSIUM 3.6 - 5.0 mEq/L 3.4 L
CHLORIDE 101 - 114 mEq/L 109
CO2 21 - 31 mEq/L 25
GLUCOSE, RANDOM 70 - 99 mg/dL 86
CREATININE 0.4 - 1.0 mg/dL 0.8
GFR/GFRAA are not calculated for results <1.3 mg/dl and patients under 18 years
of age.
BUN 8 - 20 mg/dL 11
CALCIUM 8.6 - 10.3 mg/dL 9.4
ANION GAP, SER/PLAS 2.0 - 13.0 mEq/L 6.0
General Information
Dehydration, anemia, malnutrition
Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Jyothi BL and I will be answering your query.
After going through your query, my opinion is as follows:
1. The kidney stones with cysts would explain your back pain.
2. Abdominal pain along with throwing out, possible gastritis. As you are passing stools, obstruction can be ruled out. Internal hemorrhoids would not cause vomiting. Sluggish colon could be due to low fiber diet or in response to internal hemorrhoids. So many medications - drug induced gastritis could be present.
3. The laboratory values are variable. Most of them are within the normal range.
I do have few questions to ask:
a. You are having continuous fever since 74 days, and was there no blood culture, stool culture or urine culture done? Your thyroid values are within normal range.
b. You have not attached any hematological reports, particularly hemoglobin/rbc count. Anemia can possibly explain many of the symptoms.
c. You are also on many CNS medications and interactions between all these can give you constant fatigue. When were these medications started? Is there any possible correlation?
d. Despite of so many medications, you are not on any antacids or proton pump inhibitors to reduce gastritis?
e. How much weight have you lost since admission? Malnutrition, vomiting, stool softeners all together would be causing nutritional deficiency along with severe dehydration. Loss of arm hair, body hair appears to be nutritional and fatigue can be seen in severe dehydration or anemia.
f. Were you started on any antibiotics for fever anytime?
g. Double stranded DNA antibody is negative. So few autoimmune diseases ruled out. Any other tests done?
Improve intake of fluids and nutritional diet. Attach hematological results along with Vit B12 assay. Medications for gastritis should help you reduce abdominal pain and for vomiting anti-emetics should be helpful.
If you attach all reports you have, I can help you more.
Take care.
Dr. Jyothi BL

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