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Suggest Treatment For Gastroparesis And Gastritis
Question: TO BE ANSWERED BY DR. SHUBA XXXXXXX .....IT SEEMED OUR COMVERSATION HAD BEEN CLOSED....IF YOU WOULD REPLY TO ME I WOULD LIKE TO CONTINUE OUR DECUSSION BEFORE MY TIME RUNS OUT ON AUGUST THE 1ST.
THANK YOU
XXXX
THANK YOU
XXXX
Brief Answer:
Sure Ms. XXXX
Detailed Answer:
Hello Ms. XXXX,
I am sorry. I do not know how the conversation got closed.
I would only be happy to help and continue our discussion.
Please get back to me.
What do you mean by 'time runs out by Aug 1st'?
Hope all is well
Regards,
Dr. Shuba Hariprasad
Sure Ms. XXXX
Detailed Answer:
Hello Ms. XXXX,
I am sorry. I do not know how the conversation got closed.
I would only be happy to help and continue our discussion.
Please get back to me.
What do you mean by 'time runs out by Aug 1st'?
Hope all is well
Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
Hello Dr. XXXXXXX
Thank You for getting back to me. According to this website my chatting with you and the money I paid will only pay for your services and information to me for one month. From July 5th until August 1st. Which isn't a full month, really. The reason they stated to me was that I did not respond to you within 3 days of your last response to me, but I did, for some reason the site did not send my message and it reset like you explained it had done to you. So you never received my response to you. I sent them a note and explained we had both had issues with the site so they told me to send the message directing my question to be answered only by you.
Okay....as far as the endoscopy...along with the H. Pylori, it also showed gastroparesis, and gastritis. No ulcers were mentioned. She hasn't mentioned a repeat endoscopy to check and see if the digestion of my food has changed at anytime in the future.
I have had a migraine for the past 3 days and was unable to go to my appointment this week to see her so now I have to wait until September 2nd, unless I can get in on a cancellation or they can and will work me in. I am very sad I can't get in before then. That's 5 weeks away. I didn't have anyone to drive me to my appointment and I am too sensitive to the bright sunshine with a migraine, I can't take the risk of driving. It's been in the upper 90 degrees here this week, with extremely high humidity, with nothing but bright sunshine and I haven't been able to be in any kind of light. I can't do much on my iPad because the light of the screen bothers me after just a few minutes. I have it turned down to where I can barely see it.
My Cholesterol levels when tested the last time on May 10, 2016 were...
HDL Ratio...8.3
HDL...........23mg/dl
Cholesterol Total 192 mg/dl
LDL Calculated 100mg/dl
Triglycerides 343mg/dl
As far as my digestion and diarrhea, it comes in spells. I am not regular with my bowel movements, every 3-4 days I may have a bowel movement some are very soft to diarrhea. With the diarrhea I have a day or so of lower stomach cramping and the feeling of needing to go and the urge, but nothing will pass on thru me. Then when it finally does it very painful in my lower stomach. For a week of more now it's been very tender in what I think would be my lower colon. I don't know what it is exactly. I don't have discomfort when I urinate, so I am thinking it has to be my bowels. I am still drinking plenty of water. I see my GP Dr. on Wednesday this coming up week and I am not looking forward to that visit.
He is going to be upset because I am not taking any diabetic meds as he prescribed and I will refuse to take any if he prescribes me something with Metformin in it and then Questran to stop the diarrhea. My A1C is down to 6.3 from 7.3 and according to the levels on my test sheet 6.299 is within the normal range. Yes I know it's still elevated but I have worked so hard, even being off the medication to keep it low. I guess we will see what my tests show if he does blood work this visit. Testing it at home daily it's still around 90-100.
I sent you a friends request on your Facebook page, but I noticed you don't use it much. I was looking a way to reach out to you off this site. I want to thank you for all the help you have offered me in our discussions and the trust you have instilled in me for being so helpful. Even though we are on opposite sides of the world, I consider you a friend as well as a Dr. who has given me so much more than information. You have given to me the strength and courage to stand up for myself with my health care providers who I deal with in person. Thank you.
I will wait to hear from you next.
Again thank you,
XXXX
Thank You for getting back to me. According to this website my chatting with you and the money I paid will only pay for your services and information to me for one month. From July 5th until August 1st. Which isn't a full month, really. The reason they stated to me was that I did not respond to you within 3 days of your last response to me, but I did, for some reason the site did not send my message and it reset like you explained it had done to you. So you never received my response to you. I sent them a note and explained we had both had issues with the site so they told me to send the message directing my question to be answered only by you.
Okay....as far as the endoscopy...along with the H. Pylori, it also showed gastroparesis, and gastritis. No ulcers were mentioned. She hasn't mentioned a repeat endoscopy to check and see if the digestion of my food has changed at anytime in the future.
I have had a migraine for the past 3 days and was unable to go to my appointment this week to see her so now I have to wait until September 2nd, unless I can get in on a cancellation or they can and will work me in. I am very sad I can't get in before then. That's 5 weeks away. I didn't have anyone to drive me to my appointment and I am too sensitive to the bright sunshine with a migraine, I can't take the risk of driving. It's been in the upper 90 degrees here this week, with extremely high humidity, with nothing but bright sunshine and I haven't been able to be in any kind of light. I can't do much on my iPad because the light of the screen bothers me after just a few minutes. I have it turned down to where I can barely see it.
My Cholesterol levels when tested the last time on May 10, 2016 were...
HDL Ratio...8.3
HDL...........23mg/dl
Cholesterol Total 192 mg/dl
LDL Calculated 100mg/dl
Triglycerides 343mg/dl
As far as my digestion and diarrhea, it comes in spells. I am not regular with my bowel movements, every 3-4 days I may have a bowel movement some are very soft to diarrhea. With the diarrhea I have a day or so of lower stomach cramping and the feeling of needing to go and the urge, but nothing will pass on thru me. Then when it finally does it very painful in my lower stomach. For a week of more now it's been very tender in what I think would be my lower colon. I don't know what it is exactly. I don't have discomfort when I urinate, so I am thinking it has to be my bowels. I am still drinking plenty of water. I see my GP Dr. on Wednesday this coming up week and I am not looking forward to that visit.
He is going to be upset because I am not taking any diabetic meds as he prescribed and I will refuse to take any if he prescribes me something with Metformin in it and then Questran to stop the diarrhea. My A1C is down to 6.3 from 7.3 and according to the levels on my test sheet 6.299 is within the normal range. Yes I know it's still elevated but I have worked so hard, even being off the medication to keep it low. I guess we will see what my tests show if he does blood work this visit. Testing it at home daily it's still around 90-100.
I sent you a friends request on your Facebook page, but I noticed you don't use it much. I was looking a way to reach out to you off this site. I want to thank you for all the help you have offered me in our discussions and the trust you have instilled in me for being so helpful. Even though we are on opposite sides of the world, I consider you a friend as well as a Dr. who has given me so much more than information. You have given to me the strength and courage to stand up for myself with my health care providers who I deal with in person. Thank you.
I will wait to hear from you next.
Again thank you,
XXXX
Brief Answer:
Hello
Detailed Answer:
Hello Ms. XXXX,
I was wondering what happened to our earlier discussions. Sorry about this.
Thank you for the clarifications.
-your triglyceride levels are high and HDL low. It needs to be reversed.
Did your GP change or increase the dosage of medications for these (atorvastatin).
Questran helps to lower cholesterol as well but should be used cautiously when given in addition to to atorvastatin, especially in a situation where the intestinal motility is affected.
- on your next visit with the GP, ask about this. HDL is the good fat and needs to be between 60-80, for it to be beneficial to your heart and blood vessels.
Eating natural sources of omega 3 fatty acids and healthy fat (avocado, fish, walnuts for instance ) , Fibre, green leafy vegetables, including whole grains and avoiding refined ones can help with improving these levels.
Getting your sugar levels under control also help.
*please check your blood glucose levels 2hours after a meal and let me know the values. Do this for all your major meals. ( not snacks)
Sorry that you missed your appointment. Hope you feel better now.
The tenderness in your lower colon,
-is it to any one side? (to the left, for instance)
-do you feel pain only while you have to go to the restroom or even otherwise?
-what sort of a pain is it?
-any mucus or blood in the stool?
-any change in stool consistency? Any fever?
When the Intestines move slowly, there is a change that Fecal matter can get stuck in small pouches along the wall of the intestine. This can cause inflammation and infection (Diverticulitis).
Don't worry about what your GP is going to say. Just try to get the answers to questions that you need answered.
- other medications for diabetes please (take your daily glucose reading along with you to show him)
- triglycerides lowering and HDL increasing medications /supplements
-to examine you for the abdominal pain you have.
- referral to an endocrinologist (maybe if you have a letter, you can see one outside the circle of doctors). It doesn't make sense that you geographic location or the physician circle doesn't allow you to get the medical care you need.
You can insist for an endocrinologist (at least a Second opinion) for aiding treatment in diabetes.
This will be difficult but keep your calm and just focus. Most people will actually listen if you insist on making yourself heard without offending them.
I am rarely on Facebook, don't have the time for it really. I do have an email where you can reach me.
It's YYYY@YYYY .
I must say that my schedule is hectic but I assure you that I will do my best to reply ASAP.
Let me know how your appointment goes with your GP.
Wish you well Ms. Faye and I am glad to have been of assistance.
I will be happy to be your friend.
Regards,
Dr. Shuba Hariprasad
Hello
Detailed Answer:
Hello Ms. XXXX,
I was wondering what happened to our earlier discussions. Sorry about this.
Thank you for the clarifications.
-your triglyceride levels are high and HDL low. It needs to be reversed.
Did your GP change or increase the dosage of medications for these (atorvastatin).
Questran helps to lower cholesterol as well but should be used cautiously when given in addition to to atorvastatin, especially in a situation where the intestinal motility is affected.
- on your next visit with the GP, ask about this. HDL is the good fat and needs to be between 60-80, for it to be beneficial to your heart and blood vessels.
Eating natural sources of omega 3 fatty acids and healthy fat (avocado, fish, walnuts for instance ) , Fibre, green leafy vegetables, including whole grains and avoiding refined ones can help with improving these levels.
Getting your sugar levels under control also help.
*please check your blood glucose levels 2hours after a meal and let me know the values. Do this for all your major meals. ( not snacks)
Sorry that you missed your appointment. Hope you feel better now.
The tenderness in your lower colon,
-is it to any one side? (to the left, for instance)
-do you feel pain only while you have to go to the restroom or even otherwise?
-what sort of a pain is it?
-any mucus or blood in the stool?
-any change in stool consistency? Any fever?
When the Intestines move slowly, there is a change that Fecal matter can get stuck in small pouches along the wall of the intestine. This can cause inflammation and infection (Diverticulitis).
Don't worry about what your GP is going to say. Just try to get the answers to questions that you need answered.
- other medications for diabetes please (take your daily glucose reading along with you to show him)
- triglycerides lowering and HDL increasing medications /supplements
-to examine you for the abdominal pain you have.
- referral to an endocrinologist (maybe if you have a letter, you can see one outside the circle of doctors). It doesn't make sense that you geographic location or the physician circle doesn't allow you to get the medical care you need.
You can insist for an endocrinologist (at least a Second opinion) for aiding treatment in diabetes.
This will be difficult but keep your calm and just focus. Most people will actually listen if you insist on making yourself heard without offending them.
I am rarely on Facebook, don't have the time for it really. I do have an email where you can reach me.
It's YYYY@YYYY .
I must say that my schedule is hectic but I assure you that I will do my best to reply ASAP.
Let me know how your appointment goes with your GP.
Wish you well Ms. Faye and I am glad to have been of assistance.
I will be happy to be your friend.
Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by :
Dr. Yogesh D
Dr. XXXXXXX
Thank you for your response.
I will copy your last reply and take it with me to my appointment with me on Wednesday when I see my GP and use it as a reference to discuss my concerns. It has many valid points in it and I am grateful to have them to bring up with him.
My lower stomach pain is one side or the other it's more centered to all the way across. Tender to the touch and painful inside and achy. No fever. No blood or mucous in my stool. I have trouble passing my bowel movements. Unless it's diarrhea, and that concerns me. Have my bowels over the past 6 months gotten so accustomed to just having it pushed out by diarrhea that the proper muscles have stopped working and now will not push out my stool properly? I am concerned about this, very concerned. I don't see my gastrointestinal specialist until September 2nd unless I can get in on a cancellation or an emergency I suppose. My worries are heavy and I am seriously concerned about this issue.
I am hoping I won't have a problem with my GP and my diabetic meds, because I will not go back on the Metformin or any medicine that has it in it. He is fully aware my body can not tolerate it and what it does to my body and I can't go through what I have gone through since February again.
Thank you for all your advice and the information. I will definitely was it to help me, hopefully and prayerfully get thru to my Drs..
With Best Regards My Friend,
XXXX
Thank you for your response.
I will copy your last reply and take it with me to my appointment with me on Wednesday when I see my GP and use it as a reference to discuss my concerns. It has many valid points in it and I am grateful to have them to bring up with him.
My lower stomach pain is one side or the other it's more centered to all the way across. Tender to the touch and painful inside and achy. No fever. No blood or mucous in my stool. I have trouble passing my bowel movements. Unless it's diarrhea, and that concerns me. Have my bowels over the past 6 months gotten so accustomed to just having it pushed out by diarrhea that the proper muscles have stopped working and now will not push out my stool properly? I am concerned about this, very concerned. I don't see my gastrointestinal specialist until September 2nd unless I can get in on a cancellation or an emergency I suppose. My worries are heavy and I am seriously concerned about this issue.
I am hoping I won't have a problem with my GP and my diabetic meds, because I will not go back on the Metformin or any medicine that has it in it. He is fully aware my body can not tolerate it and what it does to my body and I can't go through what I have gone through since February again.
Thank you for all your advice and the information. I will definitely was it to help me, hopefully and prayerfully get thru to my Drs..
With Best Regards My Friend,
XXXX
Brief Answer:
Please see below
Detailed Answer:
Hello Ms. XXXX,
The bowel tenderness does seem like it has an intestinal origin but other causes needs to be ruled out as well (pelvic organs like uterus, ovaries which usually includes lower back pain as well)
About your intestinal muscles- I believe it is the other way round. It is because there is a problem with the muscles or intestinal lumen that it is causing constipation and diarrhea.
I certainly hope you get answers to your queries.
Please let me know if there is anything else I can help you with.
Hoping for a speedy recovery.
Wish you well.
Regards,
Dr. Shuba Hariprasad
Please see below
Detailed Answer:
Hello Ms. XXXX,
The bowel tenderness does seem like it has an intestinal origin but other causes needs to be ruled out as well (pelvic organs like uterus, ovaries which usually includes lower back pain as well)
About your intestinal muscles- I believe it is the other way round. It is because there is a problem with the muscles or intestinal lumen that it is causing constipation and diarrhea.
I certainly hope you get answers to your queries.
Please let me know if there is anything else I can help you with.
Hoping for a speedy recovery.
Wish you well.
Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
Hi Dr. XXXXXXX
It's not an issue from uterus or ovaries, I have had all that removed. Complete hysterectomy done and both ovaries at different times. One with uterus and another 4 years later due to ovarian cysts. I am not constipated, I feel the urge to go, and I feel the stool is there to exit, but it will not exit my body. When the stool comes out its soft and not painful or hard. My pain in my lower stomach is constant but not unbearable. I have sent messages to my Drs nurse to hopefully be seen sooner than the 2nd of September, but nothing is available yet. I just called today. I will let you know how my appointment tomorrow goes. No need to reply to this message, I will send another tomorrow.
Regards,
XXXX
It's not an issue from uterus or ovaries, I have had all that removed. Complete hysterectomy done and both ovaries at different times. One with uterus and another 4 years later due to ovarian cysts. I am not constipated, I feel the urge to go, and I feel the stool is there to exit, but it will not exit my body. When the stool comes out its soft and not painful or hard. My pain in my lower stomach is constant but not unbearable. I have sent messages to my Drs nurse to hopefully be seen sooner than the 2nd of September, but nothing is available yet. I just called today. I will let you know how my appointment tomorrow goes. No need to reply to this message, I will send another tomorrow.
Regards,
XXXX
Brief Answer:
Hello
Detailed Answer:
Hello Ms. XXXX,
I didn't realize you had your uterus and ovaries removed?
-why did you have your uterus removed? And when?
I say constipation as you have fewer bowel movements than once in three days. Of course, that is commonly associated with hard stools but depends the cause of constipation. (Gastroparesis, for instance).
Adhesions (when abdominal organs stick together after an inflammatory process like a surgery) can cause pain as well. It happens years after surgery. In this case, if the pain is severe, ironically, a surgery to cut of these adhesions is indicated.
Ironically as a repeat surgery can lead to further adhesions.
If pain is not severe, medications to handle the pain, if necessary is the treatment of choice.
As you have Gastroparesis, the possibility of diverticulitis or other intestinal pathology needs to be investigated.
I don't understand why it takes so long to see a doctor when it is absolutely necessary. Is it possible to request your gastroenterologist to see you in the ER in case the pain gets worse?
-Have you ever been prescribed metoclopramide (reglan) for the Gastroparesis?
- I know your gastroenterologist didn't mention a repeat endoscopy but I recommend that a repeat endoscopy be performed with the stomach clear of its contents.
As mentioned earlier, you may need to be on intravenous fluids to clear it.
I hope to hear from you about your doctor's visit tomorrow. Hope it goes as expected.
Regards,
Dr. Shuba Hariprasad
Hello
Detailed Answer:
Hello Ms. XXXX,
I didn't realize you had your uterus and ovaries removed?
-why did you have your uterus removed? And when?
I say constipation as you have fewer bowel movements than once in three days. Of course, that is commonly associated with hard stools but depends the cause of constipation. (Gastroparesis, for instance).
Adhesions (when abdominal organs stick together after an inflammatory process like a surgery) can cause pain as well. It happens years after surgery. In this case, if the pain is severe, ironically, a surgery to cut of these adhesions is indicated.
Ironically as a repeat surgery can lead to further adhesions.
If pain is not severe, medications to handle the pain, if necessary is the treatment of choice.
As you have Gastroparesis, the possibility of diverticulitis or other intestinal pathology needs to be investigated.
I don't understand why it takes so long to see a doctor when it is absolutely necessary. Is it possible to request your gastroenterologist to see you in the ER in case the pain gets worse?
-Have you ever been prescribed metoclopramide (reglan) for the Gastroparesis?
- I know your gastroenterologist didn't mention a repeat endoscopy but I recommend that a repeat endoscopy be performed with the stomach clear of its contents.
As mentioned earlier, you may need to be on intravenous fluids to clear it.
I hope to hear from you about your doctor's visit tomorrow. Hope it goes as expected.
Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hello Dr. XXXXXXX
Unexpectedly, my visit with my GP Dr with exceptionally well yesterday. He was very interested in everything I had to say, all my questions and wanted to wait for my blood work to comeback before even thinking of any further diabetic medication. He didn't say anything about my not taking any of his former prescribed medicines I had not taken. I had extensive blood work done and some of the results were of course returned quickly. My white blood count is highly elevated in the 18.000 range so I have to see my oncologist on Tuesday of next week. I also have been diagnosed with Leucosytosis. I feel like everything with my blood has gone crazy. Still waiting for other test results as far as blood glucose and A1C results. Triglycerides levels are extremely elevated. 343 is the level. He has put me on a very high dose of fish oil. Vacepa, is the name of it. Also my Vitamin D is low which is something I face most of the time. So I will start on my Vitamin D again. 50,000 IU 3 X weekly. Usually for 12 weeks. Those are the only the meds he changed. He was so supportive and understanding. So it well and so much better than I had thought it would. I see him in 3 months unless I need him before. He told me never hesitate to call if I need to see him ahead of time. I was very surprised about the visit. He discussed my cholesterol and advised me on that and that is why he prescribed the fish oil. He is concerned about the LDL level, the HDL he said was not so bad to be concerned about. Not as it has been in the past. He commended me for eating yogurt, as the probiotics wer good for me. He wants me to know there is help for my gastroparesis and not be afraid that nothing can be done. The elevated white blood cells could easily be from the digestive infections and not to worry too much. He just wants to be on the side and send me to my oncologist, just on the side of caution.
So that's about it. So much going on in my mind right now. I may have omitted something if so, I write you another note. This chat will end the 1st of August so further correspondence will be thru your email. If that is ok with you. Any further lab results will come in within the next couple of days.
Again, Regards,
XXXX
Unexpectedly, my visit with my GP Dr with exceptionally well yesterday. He was very interested in everything I had to say, all my questions and wanted to wait for my blood work to comeback before even thinking of any further diabetic medication. He didn't say anything about my not taking any of his former prescribed medicines I had not taken. I had extensive blood work done and some of the results were of course returned quickly. My white blood count is highly elevated in the 18.000 range so I have to see my oncologist on Tuesday of next week. I also have been diagnosed with Leucosytosis. I feel like everything with my blood has gone crazy. Still waiting for other test results as far as blood glucose and A1C results. Triglycerides levels are extremely elevated. 343 is the level. He has put me on a very high dose of fish oil. Vacepa, is the name of it. Also my Vitamin D is low which is something I face most of the time. So I will start on my Vitamin D again. 50,000 IU 3 X weekly. Usually for 12 weeks. Those are the only the meds he changed. He was so supportive and understanding. So it well and so much better than I had thought it would. I see him in 3 months unless I need him before. He told me never hesitate to call if I need to see him ahead of time. I was very surprised about the visit. He discussed my cholesterol and advised me on that and that is why he prescribed the fish oil. He is concerned about the LDL level, the HDL he said was not so bad to be concerned about. Not as it has been in the past. He commended me for eating yogurt, as the probiotics wer good for me. He wants me to know there is help for my gastroparesis and not be afraid that nothing can be done. The elevated white blood cells could easily be from the digestive infections and not to worry too much. He just wants to be on the side and send me to my oncologist, just on the side of caution.
So that's about it. So much going on in my mind right now. I may have omitted something if so, I write you another note. This chat will end the 1st of August so further correspondence will be thru your email. If that is ok with you. Any further lab results will come in within the next couple of days.
Again, Regards,
XXXX
Brief Answer:
Yes please get back to me by email
Detailed Answer:
Hello Ms. XXXX,
Glad to know that your appointment went well.
Leucocytosis (increased white cell count of 18000) has to be investigated as rightly suggested by your GP.
-did they do a differential count? (of the white blood cells) or a peripheral smear?
-has he has for a stool analysis?
-did he examine you for the abdominal ache you had? What did he say?
Triglycerides are high.
-how much was your LDL and HDL?
Let me know the results of the other blood tests and also how your appointment with the other colorist goes.
Did you discuss about blood thinners and medications for migraine?
Please get back to me through my email.
Best wishes,
Regards,
Dr. Shuba Hariprasad
Yes please get back to me by email
Detailed Answer:
Hello Ms. XXXX,
Glad to know that your appointment went well.
Leucocytosis (increased white cell count of 18000) has to be investigated as rightly suggested by your GP.
-did they do a differential count? (of the white blood cells) or a peripheral smear?
-has he has for a stool analysis?
-did he examine you for the abdominal ache you had? What did he say?
Triglycerides are high.
-how much was your LDL and HDL?
Let me know the results of the other blood tests and also how your appointment with the other colorist goes.
Did you discuss about blood thinners and medications for migraine?
Please get back to me through my email.
Best wishes,
Regards,
Dr. Shuba Hariprasad
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Above answer was peer-reviewed by :
Dr. Sonia Raina
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