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What Could Be The Cause Of Epididymitis Even After Taking Antibiotics For Long?

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Posted on Fri, 20 Dec 2013
Question: I am very worried about this condition called epididymitis which I have. I have been on and off antibiotics for nearly one year now and I still have symptoms. does anyone know why this could be after taking so many antibiotics? also how common is tjis disease? is epididymitis a rare illness?
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Answered by Dr. Lohit K (1 hour later)
Brief Answer: Wrong drug/duration.granulomatous reaction/partner Detailed Answer: Hi XXXXX, Thanks for using XXXXXXX I went through the query and understood your concern. Epididymitis is quite rare but I used to see patients with epididymitis in my clinic. Since you are suffering for 1 year, it is referred as chronic epididymitis. The recurrence may be due incomplete treatment for the infection, wrong drug or for wrong duration or may be due to granulomatous reaction like Mycobacterium tuberculosis (TB). Even from your partner (if infected and not treated for it) re infection to you is possible causing recurrence of symptoms. So to diagnose the cause and for appropriate treatment you need few investigation like 1. gram staining of urethral secretion where in WBC containing intracellular Gram-negative diplococci may suggest gonococcal infection. 2.To rule out the diagnose of any granulomatous reaction get done USG of external genitalia where you can see bilateral enlarged hyperemic epididymis with multiple cysts and calcifications. In these patients usually the symptoms worsens even with antibiotics. 3. Examination of your partner for gonococcal /other infection For emperical therapy with your doctor's advice you can take Ceftriaxone 250 mg IM in a single dose with Doxycycline 100 mg orally twice a day for 10 days. Hope this information answered your query and is helpful for you. Feel free to ask if any related query and I will be glad to answer them. If you like my answers kindly rate it, and write a review as well. Wish you a very happy life and good health. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (1 hour later)
how would they diagnose tuberculosis epididymitis? I have never had tuberculosis as a child. Please advise.
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Answered by Dr. Lohit K (9 hours later)
Brief Answer: Mantoux test, USG external genetalia Detailed Answer: Hi, Yes the tuberculosis epididymitis can be diagnosed by using USG of external genitalia where you can see bilateral enlarged hyperemic epididymis with multiple cysts and calcifications. Along with this tuberculin or PPD test (Mantoux test) will help you. The ESR and lymphocyte count may be raised. This is a rare condition since you have not exposed to TB patients. The USG and proper examination will give us the better picture in diagnosing the cause. Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (3 hours later)
I live in the uk where tb is pretty rare. I had a ultrasound of my testicles about 1 year ago which showed left epididymis has being inflamed. do you think they would of picked up tuberculosis from the ultrasound scan if it was present? also when contact with a tb person how soon would the epididymitis develop and would this be picked up in blood test etc ? and what would be other symptoms?
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Answered by Dr. Lohit K (3 hours later)
Brief Answer: USG will help, Mantoux test, raised ESR,Lymmphocyt Detailed Answer: Hi, This tuberculosis epididymitis is a rare condition but will present as I mentioned earlier. So It need not be your condition but need to rule out this. The ultrasound scan(USG) will detect this. But since it was done 1 year back better to repeat it to see if any other changes has happened and this will help in diagnosing the cause. The TB has its own course, so very unpredictable, usually symptoms (pain, swelling) will be due to bilateral inflammation that is recurring even after different antibiotic therapy. There may be chances of epididymo orchitis. As explained earlier, Mantoux test will help in diagnosis and raised ESR or lymphocyte count may be present in complete haemogram. For all cause you need to give scrotal support, pain killer even with & after antibiotic therapy. So get done USG external genitalia, complete haemogram and urethral secretion microscopy with general physical examination. This will help in planning the management. Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (8 minutes later)
how would one person contract tb epididymitis and how is it treated? also can it stay in your body for many years before appearing? my dad had tb 30 year's ago. would this be the cause?
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Answered by Dr. Lohit K (1 hour later)
Brief Answer: TB course is unpredictable. Investigations,antiTB Detailed Answer: Hi, thanks for writing back. The person will get in contact with the bacilli mainly by aerial route. But the bacteria can spread by many routes like with sputum, through clothes etc. Once the bacteria come in contact in the body they may not express then but when the immunity reduces like in diabetes, HIV or any other conditions then the bacteria may express. That is the reason I told the clinical course is very unpredictable. You may be suffering from TB or not. The cause may be due to other reason also. If suffering from TB then a course of anti tubercular drugs will clear the infection. So don't worry for it till you get done the above mentioned investigations. Hope this helps you. Wish you faster recovery. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (30 minutes later)
so if my father had tb 30 year's ago and he passed away last year of blood cancer. do you think when he fell ill with cancer he might of released the tb bacteria he had been carrying for 30 year's?
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Answered by Dr. Lohit K (3 hours later)
Brief Answer: may be possible Detailed Answer: Hi, If your father has taken complete course of anti tubercular drugs then that would have completely removed the bacilli. The bacilli can come from any person any time or might have come from your father by reactivation of any bacilli. Its difficult to tell the source of bacilli. Hope this answered your question. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (6 minutes later)
so what you are saying if a person has tb it can affect them in many different types of the body one being tb epididymitis?? also if I did have tb epididymitis then would I be carrying the tb virus? ? and could other family members catch it from me ? tb that is
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Answered by Dr. Lohit K (9 minutes later)
Brief Answer: Yes, infected person can spread to others Detailed Answer: Hi, Yes, If a person is suffering from TB he can infect others in many different ways and the other person to suffer depends on his immunity. So in case of immunocompromised the TB can flare up and presents with different clinical features. If the person take the anti TB regimen for full course then that will completely clean the infection and kill all the bacilli in him. The infection stops spreading as early as with in 1 week of starting anti TB drugs. TB is caused by bacteria and not virus.. I advice you to get evaluated for, with the above said measures as you might not have been infected by TB.The problem may be due to other cause also. Hope this answered the query. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (19 minutes later)
so if I go to the doctor tommorrow and ask for a normal tb test then epididymitis tb can be diagnosed if positive?
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Answered by Dr. Lohit K (13 hours later)
Brief Answer: Yes, we can find the cause Detailed Answer: Hi, Yes with the blood test and with Mantoux test we can detect /rule out TB. These tests will assist in diagnosing the cause. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (1 hour later)
so I can ask for a fbc and mantoux test? also would masturbation or sex during acute epididymitis spread the infection to the opposite side of scrotum? also how is fungal epididymitis diagnosed?
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Answered by Dr. Lohit K (27 minutes later)
Brief Answer: Haemogram, Mantoux,Culture. Sex has no effect Detailed Answer: Hi You need culture test in urine and semen, Mantoux test, and complete haemogram and further management will be decided according to the outcome of the results. Masturbation or sex during acute epididymitis may increase the pain due to inflammation. But usually does not have much effect in spreading the infection to other side. Very rarely that can spread to other side even if you masturbate or not. It all depends on the activity of bacteria to spread. Fungal epididymitis is very rare condition. This also presents with inflammatory signs and is present only in immunocompromised patients. Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (2 hours later)
thank your doctor but how does fungal epididymitis get diagnosed?
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Answered by Dr. Lohit K (1 hour later)
Brief Answer: clinical presentation,microscopy, culture Detailed Answer: Hi, Fungal epididymitis is diagnosed based on clinical presentation, microscopic examination of the specimen and with culture(agar culture). You can see the link I have provided for diagnosis of fungal infection. WWW.WWWW.WW Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (33 minutes later)
hi doctor as I am born and bred in the uk would epididymitis tb still be possible? also do you think this could be possible to a chronic bacterial prostatitis? if so can a semen culture show infection comming from the prostate gland? also if there is a prostate infection why is it not being totally cleared by antibiotics?? please help I am very sad. ...
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Answered by Dr. Lohit K (23 hours later)
Brief Answer: Relax,TB is rare.Culture & sensitivity will help Detailed Answer: Hi, Need not to be sad. The chances of TB epididymitis is very rare. But since chronic epididymitis you should rule out this also. If it is chronic bacterial prostatitis, then semen culture will definitely show the bacteria. The complete cure depends on the bacteria, its sensitivity to the drugs, any development of resistance to antibiotics and also property of the drugs, duration of usage etc. So culture and sensitivity test will help in selecting the antibiotics for current infection. Hope this answered your query. Wish you faster recovery and good health. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (44 minutes later)
hello dr. lohit. I have just visited my urologist. he is one of the top consultant's in the uk. I explained to him about the culture. he said it is extremely unlikely to obtain anything from prostate massage culture and it would not be worthwhile. also he said if tb epididymitis I would also have other symptoms. he says ofloxacin 200mg bd for 6 weeks is the only treatment. based on this information., please give me your thoughts? .?
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Answered by Dr. Lohit K (4 hours later)
Brief Answer: Can take Ofloxacin. Follow up regularly Detailed Answer: Hi, Ofloxacin is a drug with better tissue penetrability and hence will act in nongonococcal and also mixed Infections of the urethra & Prostate. It is the second line of treatment against N. Gonorrhoeae. Patients with epididymitis most often will be infected with N. gonorrhea and hence the first line of treatment I prefer is ceftriaxone combination treatment as explained before. ( Ceftriaxone 250 mg IM in a single dose with Doxycycline 100 mg orally twice a day for 10 days) This will cover both gonococci and C. Trachomatis. (Patients infected with N. gonorrhea frequently are coinfected with C. trachomatis). So based on your previous treatment history, clinical examination and chronicity your doctor has selected Ofloxacin which is recommended for epididymitis. You can get more information in the following site. WWW.WWWW.WW WWW.WWWW.WW Yes, As told before TB epididymitis is rare and presents with granulomatous lesions which shows bilateral enlarged hyperemic epididymis with multiple cysts and calcifications. It is good that your doctor has ruled out after examining you. Since chronic infection I wanted you to rule out this. If the prostate is infected the secretion show the organism on culture. After examination your doctor is sure of ruling out prostatitis and hence he is confident in telling that no bacteria can be isolated in secretion. So in summary, you can continue Ofloxacin as advised by your doctor (It is always best to follow the local specialists advice) and have regular followup with him till the treatment is completed. Better is to take an Injection of ceftriaxone 250 mg with your doctor's advice along with symptomatic treatment which may help you. Kindly go through the link I have provided you which will help in understanding the disease and its management. Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (8 minutes later)
hi dr. lohit the urologist says that I have chronic bacterial prostatitis but he is saying that it is impossible to culture the bacteria after massage as it will show nothing. what are your thoughts on this?? Secondly is prostate massage something I can do myself or my partner can do for me? ? also can prostatitis be cured by prostate massage? ? please advise.
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Answered by Dr. Lohit K (19 minutes later)
Brief Answer: Most Common: nonbacterial prostatitis.Massage may Detailed Answer: Hi, Chronic prostatitis may be bacterial or non bacterial (most common and the cause is not known). Bacterial prostatitis is characterized by recurrent urinary tract infections in men. Hence your doctor has told impossible to culture the bacteria after massage as it will show nothing since you don't have repeated UTI to suggest bacterial prostatitis. These infections get into the prostate from the urethra by backward movement of infection into the prostate ducts. If infected (prostatitis) then only antibiotic therapy is required or else symptomatic therapy is enough. Prostate massage may help you in treatment if suffering from prostatitis, but not sure how much it will help you as there is very little evidence. So continue the treatment with prostate massage. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (24 minutes later)
dear dr. lohit can prostate massage be done at home? can my wife do it for me? also one other question sir, can non bacterial prostatitis cause epididymitis? ?
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Answered by Dr. Lohit K (1 hour later)
Brief Answer: your wife can do. prostatitis cannot spread to Detailed Answer: Hi. Yes your wife can do it for you but she needs to learn it with the assistance of videos, web based information and a sister(best way to learn). She should take aseptic precautions. the non bacterial prostatitis won't spread to cause epididymitis, but the inflammatory reactions can affect epididymis causing discomfort. Hope this helps you. regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (11 minutes later)
hi dr.lohit so non bacterial prostatitis can still inflame the epididymitis without infection? ?
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Answered by Dr. Lohit K (11 hours later)
Brief Answer: Inflammation can occur without infection Detailed Answer: Hi, Yes. Infection is due to any organism, may be by bacteria or virus or fungus etc. But inflammation is the response to them and also it may occur due to irritation, pressure due to mass effect etc.. So there may be inflammation without infection but infection most often will be associated with inflammation. Hope this clarified your doubts.. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (49 minutes later)
sir is chronic bacterial prostatitis a rare diseases and can it be cured ??
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Answered by Dr. Lohit K (20 minutes later)
Brief Answer: Not uncommon, but can be cured. Detailed Answer: Hi, It can be cured. The chronic bacterial prostatitis is not uncommon. The problem is relapse even after the treatment. The mainstay in the treatment is oral antimicrobial agents. The most effective medications are fluoroquinolones (ofloxacin) and TMP-SMZ. Longer courses of antibiotic use provide better treatment outcomes. Since bacterial prostatitis is rare, if the post prostatic massage urine culture results are positive, then successful treatment is likely. So since you are taking Ofloxacin, this should help in curing chronic bacterial prostatitis if present even without the culture. Also take anti inflammatory drugs as this will help in managing the inflammation and also non bacterial prostatitis. So be relaxed and continue the treatment now and follow up regularly with your doctor. This should help you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (29 minutes later)
hi dr. lohit how long is the antibiotics sometimes months I would imagine? so is cbp a rare disease or do other people get it also? I feel so sad that only I have this? please advise....
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Answered by Dr. Lohit K (8 hours later)
Brief Answer: 2-9% suffer.Antibiotics 4-6week Detailed Answer: Hi, I can understand your concern. CBP is a common disorder. It affects around 2-9% of people. For this the management requires quinolone for 4-6 weeks and repeat courses may be necessary if not completely treated. Along with this analgesia (NSAID) and also stool softeners may be required. Daily exercise, plenty of water, stress management and relaxation techniques will help you. If the antibiotic is not helping you then you can add prazosin with your doctor's advice as one of the recent review suggested the combination of antibiotic quinolone with prazosin (alfa blocker) may provide the best outcomes in CBP. Anothaisintawee T et al; Management of chronic prostatitis/chronic pelvic pain syndrome: a systematic JAMA. 2011 XXXXXXX 5;305(1):78-86. So for now continue the antibiotic with NSAID, dairly exercise and relaxation techniques. This will help you. Hope this information helps you in managing CBP. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (34 minutes later)
thank you so much dr. lohit. you are like a god. do people with cbp leave work or continue with routine life ? also when I take nsaid I get stomach problems. is there any othet alternative anti inflammatory available please ? ?
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Answered by Dr. Lohit K (24 minutes later)
Brief Answer: Continue work.nimesulide, meloxicam Detailed Answer: Hi, With CBP, you can continue your work. Wear testicular support inner wears. You should continue your routine activities. NSAID like nimesulide, meloxicam has less gastric problem with good anti inflammatory effect. You can try these. Other drugs with anti inflammatory effect are steroids and montelukast. But you can't try steroids for long duration. Montelukast may help you but it is not indicated for this use. So better is to use nimesulide or meloxicam. Hope this helps you. So be relaxed and continue the treatment. Your problem will be relieved with the above said measures. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (34 minutes later)
hi dr. lohit, what can I do to promote blood supply to my prostate gland to ensure the antibiotics can penetrate it well ? also is there any exercises I can do ? will daily ejaculation help the problem sir ? please advise. yours sincerely. ..
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Answered by Dr. Lohit K (12 minutes later)
Brief Answer: No drug to increase specific prostate blood supply Detailed Answer: Hi The Ofloxacin has good tissue penetrability. Only increase in blood supply will not help, the drugs property to penetrate into prostate and its secretion should be there to kill bacteria present over there. There are no specific drug that will increase blood supply to prostate gland. Exercise means the prostatic massage will help. Daily ejaculation may or may not help you. There is no evidence on it. But with daily ejaculation the chance of bacterial colonization may reduce and may help, but since there is no evidence I can't comment on it. Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (8 minutes later)
hi dr. lohut. so do you recommend I do kegal exercises to promote blood supply to the prostate? also dr.lohit you sound very experienced in this area. are you a urologist?
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Answered by Dr. Lohit K (9 minutes later)
Brief Answer: Yes you can try kegal exercises Detailed Answer: Hi the kegal exercises are pelvic floor exercise. This may help you as it increases the blood supply to pelvic area and you can try this. This is mainly indicated to control bladder function. I treated few of my patients with similar complaints and I follow evidence based medicine. So I am updated on managing this. Thanks for appreciation :-), I am not urologist. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (5 minutes later)
hi dr.lohit, finally is there anything I can do to stop the antibiotics upsetting my stomach as they are causing bloatness? shall I take them only with food ?
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Answered by Dr. Lohit K (12 minutes later)
Brief Answer: Take with food. 300mg is preferred Detailed Answer: Hi XXXXX I prefer Ofloxacin 300mg twice daily. You can discuss with your doctor for the dose change as it is recommended to use 300mg. This drug can cause gastric discomfort so you can take after food to minimize the discomfort. Never take with antacid or sucralfate (Syrup used in gastritis) as they decrease its absorption. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (29 minutes later)
hi dr. lohit can I take priobotics? Sir how many patients have you cured with cbp ? is it curable im extremely frightened?
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Answered by Dr. Lohit K (10 hours later)
Brief Answer: Probiotics may help. Its curable.Relax Detailed Answer: Hi XXXXX, I can understand your concern and pain.. Probiotics may help since you have to take long term antibiotics. Have probiotics, curd, yogurt. You need to be adherent to the treatment. I had cured around 15-18 patients. They are happy now without symptoms. It is curable but need to follow your doctor's instruction. 1st of all is be relaxed, hope for best and believe in treatment. Engage in daily routine activities, out door exercises and good nutritious diet. These will definitely cure you. Wish you faster recovery and good health. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (1 hour later)
hi dr.lohit, is this out of hpw many patients with cbp? also doctor has said 200mg bd is this the wrong dosage?
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Answered by Dr. Lohit K (42 minutes later)
Brief Answer: Adhere to treatment. Oflox 300mg BD for 42 days Detailed Answer: Hi 2-3 patients with incomplete treatment dint recovered. One patient lost to followup after initial improvement. So If incomplete treatment or if you don't follow your doctors instruction then the chance of treatment failure may be high. The recommended dose is 300mg and I follow the same. For CBP 300mg BD for minimum of 42 days is recommended. So better to discuss with your doctor for the same. This drug was given in different dosages like 200 - 400mg. SO better to take 300mg but if your treating doctor suggest only 200mg then continue the same. Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (2 hours later)
hi dr. lohit my stomach is feeling a bit uncomfortable since taking the antibiotics. is there anything I can do to improve it ?
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Answered by Dr. Lohit K (1 hour later)
Brief Answer: After food. Ranitidine Detailed Answer: Hi Take drugs after food. This will reduce the discomfort. Also curd, yogurt will help you to reduce the discomfort. If not relieved you can take Tab Ranitidine 150mg twice daily 30 min before food after discussing with your doctor. This will help you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (2 hours later)
Hi dr.lohit when the treatment is completed. How will I find out that the problem has been cured? Likethe after how many days or weeks later aafter completing the treatment can the symptoms return (ifcit has not been completely cured) ?? Yours sincerely Amar.
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Answered by Dr. Lohit K (18 hours later)
Brief Answer: Absence of clinical features suggest cure. Detailed Answer: Hi XXXXXXX After completion of treatment, absence of clinical features like symptoms and signs suggests complete cure. If not completely cured then the symptoms will return in few days to weeks. You should continue other supportive measures even after completing antibiotic therapy. Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (18 minutes later)
hi dr.lohit, I was just wondering if a person has a uti what would be the symptoms? I can't recall myself having recurrent uti's as suggested in cbp. does a uti always require antibiotics or will it dissappear on its own? please yours sincerely XXXXXXX
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Answered by Dr. Lohit K (20 hours later)
Brief Answer: burning micturation,increased frequency,fever chil Detailed Answer: Hi XXXXXXX UTI can presents with many features like increased frequency of micturation, burning micturation, pain in lower abdomen or in external genitalia and associated with fever with chills. For UTI since bacteria is the causative agent the antibioric therapy is required. Many times the symptoms can occur due to ureteric colic. So need to take plenty of water and if inflammatory signs persists for more than12-14 hour then you need to take antibiotic without delay.. Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (3 hours later)
hi sir iam eating plenty of yoghurt and priobotics with my antibiotics. I still have 5 weeks remaining of my course. but my stomach does not feel too good. can my stomach improve or will it get worser over the 5 weeks?
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Answered by Dr. Lohit K (9 hours later)
Brief Answer: curd,yogurt,plenty of fluid,ranitidine. Detailed Answer: Hi XXXXXXX with the yogurt, curd, probiotics and taking drugs after food, your abdomen discomfort will improve. If you still have this problem then take ranitidine 150mg twice daily half an hour before food. This will help you. Have plenty of fluids. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (13 hours later)
thanks for your answer dr. sir what actually causes the disturbance is it because the good bacteria has been killed by the antibiotics ??
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Answered by Dr. Lohit K (3 hours later)
Brief Answer: disturbance in normal bacterial flora & acid secre Detailed Answer: Hi XXXXXXX Yes the one way of abdominal discomfort during oral antibiotic therapy is due to destruction of normal bacterial flora in the intestine. So you are taking yogurt and probiotics which will help in this case. 2nd is due to variation in the acid and mucous secretion. Good timely diet and Tab Ranitidine will take care of this. Still there may be mild discomfort which will disappear with time due to the above said measures. Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (2 hours later)
hi dr. lohit please find attached a letter from my urologist when he did recent tests. Please sir what is your opinion on their findings?
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Answered by Dr. Lohit K (18 hours later)
Brief Answer: On right treatment as there are no symptom Detailed Answer: Hi XXXXXXX I went through the attached report. This suggests that you had prostatitis. But since there are no symptoms at present and you are on treatment with ofloxacin, continue the antibiotic with anti inflammatory drugs when necessary and other supportive measures as explained before. These will cure you and also be relaxed and adherent to the treatment. Have plenty of fluids with adequate rest. Regular outdoor exercise is required. You need to followup with your doctor to look into the improvement in treatment. Hope this information helps you. I wish you a very happy disease free life. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (3 hours later)
hi dr. lohit, please can you advise on which types of outdoor activities are best? also what kind of diet I should be eating to overcome thia problem? and finally what is the cause of prostatitis and what kind of people fall in to getting this? kindest regards XXXXXXX Bhambra.
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Answered by Dr. Lohit K (1 hour later)
Brief Answer: All activities execpt weight lifting. Detailed Answer: Hi XXXXXXX The specific treatment is antibiotics and anti inflammatory drugs. All other measures are supportive. Other than weight lifting you can do all activities like walking, jogging, cycling and relaxing techniques like yoga. These will have effect on your well being and also improve your immunity. They have indirect good effect on your health. Food, as such no restriction but need to take more of green leafy vegetables and fruits with plenty of fluids. Prostatitis is caused by bacterial infection and you are already taking treatment for this. So no need to worry for it. Any body can get affected by prostatitis, but more frequently occurs due to repeated UTI. So to prevent UTI you should take plenty of fluids and take complete treatment if affected. Hope this helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (1 hour later)
hi dr.lohit so from looking at my letter you believe this is curable? also sir have you got a personal email address so I can keep ib touch with you in the future as I can then close the conversion? Regards XXXXXXX
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Answered by Dr. Lohit K (1 hour later)
Brief Answer: Yes can be curable. Detailed Answer: Hi XXXXXXX Yes this can be curable. You need to continue all medications regularly. My email address YYYY@YYYY . You can close this conversation if satisfied. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (7 minutes later)
hi dr. lohit, is there any herbal remedies which patient's can take also? and where are you based doctor on which part of India? my parents were original from punjab India and I visited last year February for short visit.
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Answered by Dr. Lohit K (21 minutes later)
Brief Answer: No specific treatment.Tab Cystone. Detailed Answer: Hi, For infection the best treatment is antibiotic. I don't know if any herbal treatment for the same. For ureteric stone formation which may cause ureteric colic and can cause repeated UTI, a tablet called Cystone from Himalaya will be effective. I am from Bangalore, South India. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (46 hours later)
hi dr. lohit my stomach upset is better on sone dayscand worser on others. can antibiotics also cause gastritis?
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Answered by Dr. Lohit K (18 hours later)
Brief Answer: NSAID can cause gastritis Detailed Answer: Hi XXXXXXX The fluoroquinilones (ofloxacin) can cause GIT side effects like nausea, vomiting, anorexia and bad taste. They don't have any direct effect gastric acid secretion. The NSAID (anti inflammatory drugs) can cause gastritis by reducing prostaglandin(PG) secretion in gastric mucosa. So taking this drug after food will minimize the GIT side effects, and if minor no need to worry as this will be better over period of time. Have plenty of fluids and fibre diet. Hope this helps you. If you are satisfied you can close the query and write a review as well. I wish you faster recovery with the treatment and good health. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (51 minutes later)
hi dr.lohit so you are saying that ofloxacin can definitely not cause gastritis? also obe question sir do you think the discomfort is caused by c.diff infection? I have no diarrheah symptoms. but mild discomfort in my stomach. Please advise? also can I take ppi tablets to overcome this or raniditine? please advise. Thanks XXXXXXX yours sincerely.
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Answered by Dr. Lohit K (21 hours later)
Brief Answer: GI symptoms rare.No C.Diffi infection.Ranitidine Detailed Answer: Hi XXXXXXX Of the fluoroquinilones, ofloxacin is well tolerated and food does not impair its absorption and hence you should continue taking it after food. Fluoroquinilones can cause GIT side effects like nausea, vomiting, anorexia and bad taste. But with Ofloxacin it is very minimal. With regular antibiotic & NSAID treatment the chance of mild gastric discomfort may present and no need to worry for it as the symptoms will disappear in time (body adjustment) and also after stoping the drugs. C.diff infection is rarely caused by Ciprofloxacin, another fluoroquinilone. The possibility of getting C. Difficile infection is very rare and you don't have any of the symptoms like constipation / diarrhea, pain abdomen etc. So no need to worry with Ofloxacin for C. Difficile infection. For Gastritis, PPI will completely stop the acid secretion and I don't prefer long term therapy with it, also ranitidine (150mg twice daily or 300mg once daily) will also be effective in reducing the acid secretion. So You can use ranitidine if required regularly and PPI if the symptoms (gastritis) increases. Hope this information helps you. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Lohit K (2 days later)
hi dr. lohit just a quick question which has been on my mind. if a chronic prostate infection was left untreated can it kill the person? ?
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Dr. Lohit K

General & Family Physician

Practicing since :2007

Answered : 1648 Questions

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What Could Be The Cause Of Epididymitis Even After Taking Antibiotics For Long?

Brief Answer: Wrong drug/duration.granulomatous reaction/partner Detailed Answer: Hi XXXXX, Thanks for using XXXXXXX I went through the query and understood your concern. Epididymitis is quite rare but I used to see patients with epididymitis in my clinic. Since you are suffering for 1 year, it is referred as chronic epididymitis. The recurrence may be due incomplete treatment for the infection, wrong drug or for wrong duration or may be due to granulomatous reaction like Mycobacterium tuberculosis (TB). Even from your partner (if infected and not treated for it) re infection to you is possible causing recurrence of symptoms. So to diagnose the cause and for appropriate treatment you need few investigation like 1. gram staining of urethral secretion where in WBC containing intracellular Gram-negative diplococci may suggest gonococcal infection. 2.To rule out the diagnose of any granulomatous reaction get done USG of external genitalia where you can see bilateral enlarged hyperemic epididymis with multiple cysts and calcifications. In these patients usually the symptoms worsens even with antibiotics. 3. Examination of your partner for gonococcal /other infection For emperical therapy with your doctor's advice you can take Ceftriaxone 250 mg IM in a single dose with Doxycycline 100 mg orally twice a day for 10 days. Hope this information answered your query and is helpful for you. Feel free to ask if any related query and I will be glad to answer them. If you like my answers kindly rate it, and write a review as well. Wish you a very happy life and good health. Regards