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Diagnosed with ulcers. Have parasitic infection and loss of appetite. What could be causing this and the cure?

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Internal Medicine Specialist
Practicing since : 2007
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My son is 17 years old. Recently diagnosed with ulcers. He is alway sick, with a cold, flu, you name it. For the last 3 years I can barely get him to eat anything. He is 5'10" and weight 128 lbs. We have taken test after test to see what is causing him to be sick all the time. He had ulcers about a year prior too. I don't know what else to do. I know something is wrong. A teen boy should love to eat and be healthy. 2 more things that I don't know if there is any importance to them but feel I need to share. 1) When my son was about 9 had a paracite in his intestine and was very sick for about 2 months 2) About 3 weeks ago I had to get a stool sample from him and noticed his stool was like a skinny worm. Not wider than a 1/4 of a inch. Any suggestions? Right now he has already missed 2 weeks of grade 11 and yesturday came down with a cold. His biggest complaint is that he is very dizzy, nauseous and sore throat.
Posted Wed, 28 Nov 2012 in Medicines and Side Effects
 
 
Answered by Dr. Kiran Kumar 39 hours later
Hi,

First of I apologize for the delay. I was travelling trans Mediterranean.

I read the query with due diligence and noted the points mentioned about your 17 yr old. He is definitely underweight for his standards.

It appears with the description that your son has parasitic infection and has lost appetite. Because of the parasitic infection he is unable to absorb crucial nutrients like minerals and Vitamins especially B12. Riboflavin deficiency (Vitamin B2) causes oral ulcers. Vitamin C deficiency causes frequent infections like cold, sore throat.

Both Vitamin B and C are water soluble vitamins. This is mainly seen in parasitic infections.

The best next step for your son:

1) He needs anti-helminthic treatment under the care of XXXXXXX Medicine Physician.

2) Your son needs external supplementation of Vitamin B12 (1500mcg/day) and Vit-B2 Riboflavin (600mg/day). You can choose over the counter supplements available at the local store with this dose.

3) Your son needs proper diet including all XXXXXXX leaves, boiled and cooked meat, vegetables and fruit. A special care should be taken. A DIETITIAN CONSULT would be worthwhile.

4) It is also important to treat the oral ulcers with local anesthetic gel 20 minutes before food else he would not eat food well and futher increases the complication.

Let me know if I missed any query. I will be happy to assist you.

Regards.

Above answer was peer-reviewed by
 
Follow-up: Diagnosed with ulcers. Have parasitic infection and loss of appetite. What could be causing this and the cure? 7 hours later
I may have not explained this properly. He has stomach ulcers and is taking lansoprazole 30mg. An example of my sons diet yesterday was, I made him pancakes and cut up cantaloupe. All he could eat was 1/2 cup of cantaloupe. He said he will get sick if he eats anything. He did not eat his lunch. Had a banana at 3:30 and went to basketball practice at 6:30-8:00 and came home to eat 1 slice of pizza and some salad. This is a normal day for my son. I can make his favorite food and he can't eat. My son doesn't always have stomach ulcers, but still eats like I have stated here. The parasites that were in his intestines was about 8 years ago which cause bleeding in his intestines for about 2 months. Is this how you understood me in my first question?
 
 
Answered by Dr. Kiran Kumar 14 hours later
No this was not the way I understood it. I understood them as oral ulcers.

Part of my earlier answer was correct about the underweight, Vitamin Deficiency and dietitian consult.

I will add the new points here.

Do you / does he notice blood in the stool? Any change in color or consistency of the same?

An adolescent having stomach ulcers is most likely a Helicobacter Pylori infection. It causes chronic gastritis. Your son needs a combination antibiotic. It is called triple therapy and your XXXXXXX Medicine physician will know about it. This should be continued for 2 weeks before review. You can confirm this infection with a simple Breath test for urease. I am sure his appetite would improve from the time it is completely treated. If he had a history of parasitic infection in the past he is most likely to have another the way you describe it now.

The pathology would lead to the deficiency that I mentioned in my previous answer. Hence I would still go with first three points and triple therapy for H. Pylori infection. This give an opportunity for the XXXXXXX Medicinist would also evaluate the other causes for underweight and nutritional deficiency.

I am not happy with his diet. He needs a definite change. Pizza, pan cake are completely processed and have no additional nutritive value for the case. It is important for him to take whole grain, boiled vegetables, fruit, cooked meat (not fried or red), egg. Start small and gradually increase the serving sizes. There may be resistance but incentivize. No carbonated drinks should be allowed as they use a lot of calcium from his bones. If continues to have aerated/carbonated he cannot play basket ball as he is now. Do you have a dietitian access they can plan it better. You can rely on appetizers or medications that increase appetite initially. Some of them available over the counter. You can take the help of the pharmacist.

Let me know if I able to connect to your need.

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