Hello and thank you for submitting your question.

Your question is a very good one and I will work on providing you with some good information and recommendations regarding the symptoms what you are experiencing.

From what you have described you have several different categories of symptoms which are currently causing problems. You have gastrointestinal as well as cardiovascular symptoms. I have to say that I am concerned about possibly a systemic degree of inflammation going on. There are several different things I would like to recommend for you as far as lifestyle modifications to see if this will actually make a difference.

The first thing I recommend is that you discontinue drinking completely. This is something you need to do to detoxify your body at this time. Your body is currently used to the fact that every day it's can count on the depressant effects of alcohol. While this may seem like a minor thing to you over time it can create a significant impact on your body. This can also have an impact on your liver function as well as cardiovascular function. During the period while you just discontinue alcohol intake I recommend you decrease it slowly over a couple of weeks. At the same time it will be important to also add a few things to your daily routine including a daily multivitamin as well as daily aerobic exercise of at least 30 to 40 min. duration.

I really think that this type of lifestyle modification will have a significant impact on you. It will not only affect your overall liver function but I believe it will have an impact on the palpitations what you have been experiencing. Also I would like you to consider the fact that sometimes there may be a electrolyte imbalance which could trigger palpitations. Particularly magnesium and potassium when they are low palpitations may occur. Along these lines I recommend you look for food which are XXXXXXX in potassium and magnesium such as fruits and vegetables. Bananas for example are an excellent source of potassium. I recommend you increase your daily intake of foods such as these for the next couple of weeks.

As far as the loose bowel movements I recommend you increase the level of fiber you intake on a daily basis. This can be done via fruits and vegetables but you also might consider purchasing and over-the-counter preparations such as Metamucil. This provides an excellent source of fiber and may help improve the bowel movements what you have been having.

Finally it may be necessary to take a look at your medications to see if there needs to be any adjustment. This is something that your primary care provider should be able to do without a problem. I recommend you do these lifestyle modifications for the next 3 to 4 weeks and then touch base with your doctor to see what kind of recommendations he or she asked for you.

Regarding the hemorrhoids I recommend that you purchased an over-the-counter preparations such as preparation H. There is a particular formulation called cooling gel which works quite well for hemorrhoids. Basically you apply a small amount to the hemorrhoids after each bowel movement for a few days. Eventually these hemorrhoids will shrink and will become less bothersome.

Regarding the fatigue I think this is all part of the systemic inflammation in your dealing with. I am quite confident that it will improve over time as you slowly work towards modifying your lifestyle to optimize your health.

I thank you again for submitting your question. I hope I have provided you with some good information and a good recommendations. I'm certainly still here for you if you would like to clarify anything or if you have further follow-up questions.

Sincerely,

Dr. Robert

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