Brief Answer:
Dyspepsia with gastritis and hemorrhoid.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query.
Have gone through all your details and i appreciate your concerns.
As per you query answers are
HIV AIDS is one of the most overhyped disease of this century.
Trials have shown that even if unpreotected sex is done with a patient of AIDS in full viremia(Last stage) chances if transmission is as low as 0.1% and this is about high viremia phase.
As all your tests till date are normal i dont think worrying about HIV is required.Just forget that and move on.

As per your query regarding Hepatitis.Go to the nearest path lab and get a test named HBsAg.If the test is negative you don't have hepatitis.

Now lets come to problems of Gastroenterology.
Firstly Irritable bowel syndrome is a diagnosis of exclusion.So without performing baseline tests like Endoscopy or Colonoscopy its not in protocol to label patient as IBS.

More over your symptoms are clearly suggestive of severe gastritis and dyspepsia.Smoking and alcohol irritates the lining of stomach and causes parietal cells in stomach to secrete lots of acid.This acid refluxes back into esophagus causing pain inflammation and heaviness with heartburn.
Our gut consists of million of good bacteria which are responsible for proper digestion of food specially carbohydrates.
Excessive smoking alcohol and poor food habits destroys this good flora hence causing indigestion.The carbohydrate is incompletely fermented causing release of large amount of gases in gut.
Suggestion are-
Start taking syrup Mucaine gel 2 table spoon thrice daily before lunch breakfast and dinner.
Tab Rablet l to be taken once daily 7 am
They are going to take care of your dyspepsia acid reflux bloating and gastritis
Take a good quality probiotic like Econorm twice daily for few weeks.It will help to replete the disturbed G.I flora.


Blood in stool and sensation in anus are mist likely due to hemorrhoids.Go to a surgeon and ge will perform digital rectal examination along with proctoscopic examination to rule out the possibility of hemorrhoid.
Once confirmed-
start using Prepration H (or Ruticool a combination containing contains Calcium Dobesilate, Hydrocortisone, Lignocaine, and Zinc.) locally over hemorrhoids.

Ask your gastroenterologist to prescribe you with oral Calcium Dobesilate-Doxium therapy for 3 months. Initially twice daily for 21 days followed by once daily for 10 weeks. Trials have shown that 3-month therapy can cause shrinkage of Hemorrhoids in almost 60% cases.It was demonstrated that calcium dobesilate decreased capillary permeability, inhibited platelet aggregation and improved blood viscosity; thus resulting in reduction of tissue edema.

Add Metamucil/Fybrogel to your regimen. It's a natural laxative containing husk. It absorbs water from the intestine and swells up making passage of stool easy and add bulk to stool.Take it 2 tsf twice daily with half cup of XXXXXXX warm milk.



Suggestion-

Avoid alcohol and smoking.
Drink 2 cups of cold milk daily.
Proper food habits are very essential to control excessive flatulence.
Avoid-
Dairy products, which contain sugar lactose that causes gas.
Vegetables, including onions, radishes, cabbage, celery, carrots, brussel sprouts, broccoli, cauliflower and legumes.
Fruit sugar, which is especially high in prunes, raisins, bananas, apples, apricots and fruit juices from prunes, grapes and apples
Fiber.
Fatty foods and carbonated drinks.

Eating more fermented foods. These are rich in both good bacteria and enzymes you can try raw natto kefir or cultured veggies. This is probably one of the most important first steps.
Taking a high-quality probiotic.
Exercising, to help keep food moving through your system.
Using spices that may help to prevent flatulence. These include turmeric, coriander, peppermint, fennel, sage, chamomile and ginger.

Dont drink juices they cause acidity.
Anxiety stimulates vagus nerve causing secretion of large amount of acid in stomach.So try to control your anxiety levels otherwise consider taking Anxiolytics like Lorazepam once daily for few days.

Suggestions-
A planned endoscopy should be done to rule out possibility of peptic ulcers.

Follow what ever i suggested and you will feel better in 2-4 weeks.

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Brief Answer:
Follow up suggestions.

Detailed Answer:
Hi again Dear Patient,

Answers are-

1)Frankly speaking no its not Hepatitis. presenting complaint of patient with Hepatitis(B,C Sexually transmitted) is severe jaundice(yellowing of eyes) with nausea,vomiting,Malaise fatigue and extreme letharge. Hepatitis means inflammation of liver cells.When liver cells are inflammed they become permeable to enzymes stored inside them hence Liver function test including bilirubin are grossly deranged in hepatitis.This bilirubin accumulates in cornea of eye causing yellowing of cornea.
2) I have read lots on google and confused and worried about Hep. a lot as its a very dangerous and not curable deceases-Hepatitis B and C is well controllable and patient can lead a normal life -Don't google too much its helpful when you know the basics.

2)Antibiotics have no role in treatment of IBS.

-Even after taken Taxim oz for 5 days and cyfolac ( daily 2 tab) ( today was last dose ) still i get pains coming and going in center of stomach and under diaphragm and below right and left ribs bout not as before the taking tablet ( i read these are first symptoms of hepatitis?

No They are not classical signs of hepatitis rather they are tell tale sign of Gastritis heartburn and GERD.

Though i have explained all symptoms above but if your mind is still not satisfied see symptoms on reliable sites like Mayo.

Suggestion are-
Start taking syrup Mucaine gel 2 table spoon thrice daily before lunch breakfast and dinner.
Tab Rablet l to be taken once daily 7 am
Pain would be much better in few days.

3) Due to excessive smoking and liquor and having unhealthy food mucosa layer covering you gut is inflammed.This inflammation in stomach area is described as Gastritis or GERD while in anal area is termed as hemorrhoid(initial stage).

Your digestive system is crippled right now and complete treatment is required as suggested by me ion previous answer.

4) so i am thinking is it related to HIV or Hepatitis infection-You have already been investigated thoroughly for HIV( possibility is 0%).
For hepatitis get a Serology test done.

I think anxiety is causing obsession.It would be better to take anti anxiety meds for few days as adviced by me earlier.

Feel free to follow up.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hello again.
Its a pleasure to answer you feel free to ask whatever you want.
1) HBsAg will be detected in an infected person's blood an average of 4 weeks (range: 2–10weeks) after exposure to the virus.
The window period is time between potential exposure to Hepatitis infection and the point when the test will give an accurate result.

2) Poor food habit and extremely unhealthy life style. I have explained this already and have also suggested you how to improve things.Please go through my initial reply.Just follow what ever i suggested and you will start feeling better in few weeks.let me give you a brief idea about what is intestinal flora.
Our body has its own enviroment called gut flora.Gut flora is the complex community of microorganisms that live in the digestive tracts of humans. The intestinal microflora is a complex ecosystem containing over 400 bacterial species. The flora is sparse in the stomach and upper intestine, but luxuriant in the lower bowel.Long term use of these antibiotics smoking alcohol eating spicy unhygenic food destroys this flora and can lead to various problems with digestive system like indigestion,constipation loose stools , bloating change in stool texture and increased gas formation.These symptoms may vary from person to person..I would suggest you to start good quality probiotics for a few days. Probiotic mechanisms of action include enhancement of the epithelial barrier, increased adhesion to intestinal mucosa, and concomitant inhibition of pathogen adhesion production of anti-microorganism substances and modulation of the immune system.In LAY MANS language it contain a lot of bacteria's which forms a part of normal gut flora.


Kindly go back through my initial and follow up reply i have already adviced you everything.

Even after that if you have some doubt feel free to ask.

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Brief Answer:
None of the symptoms is suggestive of hepatitis.

Detailed Answer:
Hi again XXXXXXX
Thanks for follow up.

Initially, before answering your question let me give you a briefing,

Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over. In your case obsession is your fear of hepatitis B and compulsion is your mind thinking again and again about that, despite repeated clearance from various specialties...


Some features of OCD are-
Not able to control his or her thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive

Spends at least 1 hour a day on these thoughts or behaviors,
Experiences significant problems in their daily life due to these thoughts or behaviors,

So my first suggestion would be to suppress your obsession about Hepatitis;

Start paroxetine at low doses to be increased every 14 days to maximum doses (to be prescribed by a psychiatrist)- This is the mainstay of therapy.

Request him/her to add tab Clonazepam or Lorazepam ( benzodiazepines), to lessen your anxiety levels.
These drugs should be discussed with your psychiatrist before use.

Try to take 8 hours sleep, try strenuous exercises 45 minutes a day, yoga can be done to relieve your mind.

Follow these advices for 3 months, and you should be fine.

Now lets come to your query dear,

1) Today from 2 days i have being getting pains ( some time pains and cramps I don't know what is happening at a stretch ) below my right ribs and lot of burning sensation I am feeling now also in the right side of-of right abdomen and extends to entire back bad front stomach region with pricking sensation in outer stomach sometimes

Answer-Severe gastritis. Retrosternal chest pain involving ribs is a common feature of reflux disorder.As the acid from the stomach is refluxed back into esophagus it damages the esophageal mucosa and causes heartburn. This heartburn is felt as pain in throat and ribs. When left untreated it migrates to abdomen also.There is a possibility that these are peptic ulcers(strong history of alcohol and smoking).

A planned endoscopy should be one.
This is not at all a symptom of a patient presenting with hepatitis. As these symptoms are classical of Gastritis or ulcers.

2) Most likely a sprain or cramping due to electrolyte imbalance. It has nothing to do with hepatitis or any other sexually contracted disease.

3)Most likely its hemorrhoid dear but you need to get examined by a general surgeon for that.

Please feel free to follow up.
You are my patient and for me, it's really a pleasure to help you further.

Take home suggestion-
None of your symptoms are suggestive of hepatitis rather you are getting obsessive about your symptoms which are basically due to gastritis and dyspepsia.

Take my words XXXXXXX it's not hepatitis.
Fell free to follow up I would be glad to provide you with other details.

Thanks.

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Brief Answer:
Follow up suggestions.

Detailed Answer:
Hello again Dear,
Firstly sex is a demand of human body so don't feel bad.

1) Take the tablets as prescribed by me.

To pen down-
Cap Rablet L once daily 7 a.m(acid and bloating)
Tb XZofran 4 mg twice daily(nausea)
Cap Vizylac twice daily.(probiotic)
Syrup Mucaine gel 2 TSF thrice daily.

If after taking them for 5 days you feel constipated then add syrup looz/duphalac 15 ml once daily.

2)Your doctor i don't know who he is but try to see another doctor.This is not hepatitis its Gastritis and acid reflux disorder.

For hepatitis most essential thing is elevated levels of bilirubin and deranged liver function tests.

3) told 2 - 14 weeks and 4 being averaged which is correct -I was not taking about symptoms it as about [positive blood test.Blood test would be positive in 14 weeks.

"HBsAg will be detected in an infected person's blood an average of 4 weeks (range: 2–10weeks) after exposure to the virus."

As test is negative in your case there is no reason to doubt hepatitis however if you want repeat HbsAg test again.

If test is negative symptoms have no value.

Read about hepatitis on NCBI and Mayo official site.

Feel free to ask your queries.

Thanks.

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Brief Answer:
go for it.

Detailed Answer:
Hello XXXXXXX
Yes obviously yes dear.
Get the test named HBsAg done(will cost you hardly 4-5 dollars).
And things would be clear in next 24 hours.

Go for the test and follow up with reports.
Thanks.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hi again Dear,
Take my words report would be negative.
If your eyes are not yellow your urine is not yellow its not hepatitis.
Thanks.

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Brief Answer:
Follow up.

Detailed Answer:
Hey,
Have hone through your reports.
They are perfectly normal.
Mild elevation of bilirubin has no clinical significance.Bilirubin more then 3gram/dl is clinically significant.
Other liver function tests should be atleast 3 times the normal value to have any significance.

I can't see reports of HbsAg antigen( Done for hepatitis).

Thanks!

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