Brief Answer:
Just increased acid production triggered by stress, follow my suggestions

Detailed Answer:
Hello ma'am and welcome once again.

I can understand the description you have put forward and suspect it to be because of gastrointestinal disorder as listed in our previous discussions like gastritis, peptic ulcer disease, etc.

The symptoms are triggered by factors like:

+Stress: Which causes an increased acid production in the stomach
+Medications: Like some antibiotics, etc.
+Alcohol consumption
+Smoking
and a few others.

Your stress levels seem to be causing the increased acidity resulting in the burning sensation and pain you are experiencing. I would recommend the following for immediate relief:

+Drink plenty of water
+Avoid smoking, alcohol, spicy food, fatty food, fried food
+Preferably liquid bland food
+Lots of cold water (it will help reduce swelling and the burning sensation)
+Sucralfate suspension (syrup): This is very important and should be taken three times a day, 15 minutes before each meal, 2 tbsp each time. Take this for the next 3 months, religiously and you should hopefully never have this problem ever again.
+Also take any one of the following proton pump inhibitors: Pantoprazole, lansoprazole or omeprazole. To be taken 15 minutes before a breakfast and dinner

Please follow my instructions and I am sure you will be fine. For now, do not stress at all and try to relax as much as possible. Drink plenty of water and try to get the sucralfate syrup as soon as possible.

Please do not hesitate to write to me for any further clarifications, I am always here to help you ma'am, you should know that by now :)

Best wishes.

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Brief Answer:
An upper GI endoscopy will be required ma'am

Detailed Answer:
Hello once again ma'am.

The shoulder pain and other radiating pain and burning sensation warrants an upper GI endoscopy, and not a colonoscopy. Yes, your symptoms do match that of a possible gall bladder abnormality but can also match other abnormalities of the upper GI tract. So an upper GI endoscopy will be helpful at this point in time, not a colonoscopy.

A colonoscopy will help to visualize the lower GI tract which will help to confirm/rule out the IBS, but only when symptoms are present. But will not be helpful in visualizing and diagnosing conditions of the upper GI tract.

So please go ahead and request your doctor for an upper GI endoscopy, and not a colonoscopy ma'am.

Best wishes.

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Brief Answer:
I am always here for you Ms. Fuston :)

Detailed Answer:
Hi ma'am.

I told you, I am always here for you, and to provide you with as much information as possible.

Oh yes, the sounds and grumbling in the stomach can easily be due to IBS, as I too experience those embarrassing sounds quite often. Unfortunately there is nothing much we can do about it.

In fact, I feel it is more related to stressful situations in my case, as when I am in surgery and the entire O.T. (operation theatre) is quiet, my stomach decides to growl like a lion. :)

Best wishes.

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Brief Answer:
Could you attach an image of the pimple? Where exactly is it?

Detailed Answer:
Hi. :)

You can talk to me about anything, so nothing is off the topic.

Where exactly is this pimple and could you attach an image of it to our discussion so I can examine it and provide a more accurate and effective solution?

Thank you. :)

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Brief Answer:
Simple acne, few suggestions listed ma'am

Detailed Answer:
Hi Ms. Fuston.

Acne is a common issue with young women at your age group and should not really be an issue. But here are my recommendations:

+Avoid fried food
+Avoid oily food
+Preferably eat home made healthy food
+Lots of vegetable and fruits
+Avoid sugar based edibles and drinks
+Especially avoid carbonated drinks
+Use a topical applicant twice a day after washing your face with a mild facewash containing clindamycin and adapalene
+Avoid overuse of chemicals and cosmetics on the face
+And last but not least, drink at least 3 litres of water a day

I hope I have explained things in a manner best understood by you. Please always know, that I am here to help, anytime and regarding anything.

Best wishes. :)

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Brief Answer:
Put forward a few possibilities, vitamin B12 def

Detailed Answer:
Hi ma'am.

With the recent updates, there could possibly be (only suspecting) an issue with blood flow, causing the nausea, primarily because I suspected a vitamin B12 deficiency in you some time ago due to the swollen gums.

IBS causes a vitamin B12 deficiency, as it is very common. This happens because vitamin B12 is absorbed into the system in the large intestine, and with IBS the large intestine is swollen and does not function adequately, resulting in loss of vitamin B12 through stool, as it is not absorbed by the intestine.

Vitamin B12 is primarily involved in maintaining good blood vessel health, and when blood vessel health is poor then blood circulation can also be poor. So please get your vitamin B12 level checked at the earliest and report back to me.

Other possibilities could be:

+Vertigo: Which is a condition that causes loss of balance when there are swift head movements
+Postural hypotension: Condition in which dizziness and nausea occurs with change in posture/position due to a sudden vhange in blood pressure (e.g. supine to sitting, sitting to standing, standing and bending, etc.)
+Possible spine abnormalities

I hope I have explained things in a manner best understood by you. Please feel free to write back to me for any further clarifications, I would be more than happy to help.

Best wishes.

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