Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

147 Doctors Online
Doctor Image
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Suggest treatment for persistent sinus infection

Answered by
Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16205 Questions

Posted on Mon, 20 Mar 2017 in Blood Disorders
Question: Male, age 77, healthy. Went to an Urgent Care facility on XXXXXXX 29th for sinus infection. Routine blood check showed RBC count 4.2 on their scale of 4.5-5.9 (x10). The nurse practitioner declared me anemic and wants to send me to a G.I. doctor to start an exam. My annual exam back in Oct of 2016 showed 4.66 on a scale of 4.00-6.00. I asked for a home screen of stool samples first, but the G.I. doctor wants me to come in immediately for an endoscopy. (Also had a very good report on a colonoscopy in January 2016) Is this an over reaction? YYYY@YYYY
Answered by Dr. Michelle Gibson James 1 hour later
Brief Answer:
need to look at the MCV part of the blood test

Detailed Answer:
HI, thanks for using healthcare magic

A low rbc may indicate anemia but since it was normal a few months ago , then repeating it should be considered particularly not all type of anemia point to problems with the GI tract

Iron deficiency (low levels of iron) anemia can indicate, in some persons that there are problems with the GI tract but in that case the MCV on your blood test would be low. If you have the result , you can check this.

The MCV is done in all complete/full blood counts

The MCV can give an indicator if it is likely iron deficiency or another type of anemia. If this is normal or high then you may want to consider speaking to your general doctor about the need for endoscopy, would not likely be needed.
If it is low, then the test should be done.

Additionally the normal colonoscopy in XXXXXXX 2016, means that no lesions are likely to be there now, this is the reason that this test is scheduled years apart, lesions take years to grow.

The endoscopy would look at your esophagus and stomach , if you have symptoms related to these areas and the MCV is low then it may be necessary

If you have no symptoms and the MCV is normal or high then the need for the endoscopy should be re evaluated.

Summary: (1) since you had a recent normal test, the full blood count should be repeated
(2)a normal colonscopy a year ago means that lesions should not be present at this stage
(3)a low MCV would indicate iron deficiency anemia--- if this is the case, then you should consider testing of the upper GI tract (esophagus and stomach). One of the more common reasons for iron deficiency is a lesion in the GI tract
(4)If the MCV is normal or high then you should consider speaking to your GP about the need for further testing... not likely needed

I hope this helps,feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Michelle Gibson James 17 minutes later
Sounds logical to me. Thanks Dr. XXXXXXX
Answered by Dr. Michelle Gibson James 6 minutes later
Brief Answer:
no problem

Detailed Answer:
If you have any further issues, can let me know
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,  
Medical Procedures
Medical Topics ,  

Recent questions on  Sinus infection

doctor1 MD

I went to the Doctor's today. I was diagnosed with a minor sinus infection, but I have a resting heart rate of about 120bpm and I'm having a little difficulty breathing. Plus, I can't sleep... I know I should be exhausted, seeing that I haven't hardly slept in the last three days. Maybe a max of five hours last night, other than that two or three hours.

doctor1 MD

Hi, I m a 33 yr old female, 117 lbs, and have been on antibiotics for about 1 1/2 weeks due to a sinus infection and bladder infection- I still feel very bad. I feel weak, my heart is beating irregularly, having hard time breathing comfortably, and I have upper back pain and muscle spasms. I feel like an idiot going back to the doctor AGAIN, but I almost feel like I m going to pass out.

doctor1 MD

was diagnosed with a severe sinus infection affecting eyes, ears, throat, and bronchitis. after a week, and a round of amoxicillin and prednisone, I have been having numbness in my face (lower jaw, lips, tongue) and hands. along with general weakness and fatigue. what might cause this?

doctor1 MD

I have been using loratadine allergy pills for a long time - more then 10 years. My sinus infections are so bad that my Dr put me on C0 Betahistine, (fluid and swelling in inner ear/Eustachian tube) so I stopped using my other allergy pills (I buy them at Costco). Would I be experiencing any withdrawal from my allergy pills? I have a weird restless feeling in my body, similar to when I was having to withdraw from prescription pain meds. I am also on my 3rd round of antibiotics, this one being moxifloxacin HCI. I was supposed to have my second sinus surgery last in 2013 (previous one in 2008), but I cancelled because my knee replacement surgery has not healed, and I wanted my body to deal with one thing at a time. Sorry I thought this was a free service. Thank you, Shirley Wiebe age 61

doctor1 MD

Can you take amoxicillin and Valtrex for shingles at the same time. I have a sinus infection and my shingles has returned. YYYY@YYYY

doctor1 MD

Hello Sir/Mam, My self XXXXXXX XXXX and i m 29 yrs old.I m accountant by profession.from last 1 yr i m suffering from Sinus problem.I DAILY FEEL PAIN IN MY FOREHEAD IN MORNING NEAR 11-12 AM. AND IT IS NOT SHARP PAIN .I FEEL PAIN IN MY FOREHEAD AND...

doctor1 MD

I had a sinus infection about a month ago and right after i had a headache on the top back of my head. It was not severe but throbbing intermidiatly. Head ache long gone but the same spot is sore to the touch and i is sore if i move my head most...