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Suggest treatment fro IBS and hydrocele

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Posted on Wed, 19 Oct 2016
Question: Hello sir, I am suffering from ibs, bilateral verico. and. hydrocele since. three. yrs.but.in.march2016.i.have.feel.pain.in.my.right hip. joint.. and. both. knee also and. cracking sound in both knee also. I went to. many ortho doctors and they put me on NSAIDS, calcium, multivitamin supplements and methyl calamine injections.. I feel no permanent relief. after some time I feel pain in neck and arm also. I have done my of right hip which shows problem of bone marrow edema and mild joint effusion in femur bone. After continuing these type drugs my stomach upset and Dr said to stop all medicines and refer me immunology dept in pgi XXXXXXX because my platelets falls regularly as in march16-2.15and inAug1.50 and in September 1.25 and lever enzymes sgpt_80and sogt_56.in pgi Dr. Said for some test like tlc, dlc, hb, pt, serum creatinine, hla_b27,ferritin serum - nephrolatic, Sept, soft, all reports are normal except Sgpt, sogt are69and44 and platelets 1.25 on sept.after report he prescribed me optineuron 1ml injection, autrin cap twice in a day., evion400 folic acid tab for two months. What is up opinion sir
doctor
Answered by Dr. Naval Mendiratta (11 hours later)
Brief Answer:
Is it arthritis

Detailed Answer:
Good evening

thank you for writing on health care magic

Well, I have gone through your history and there are some patches which if you can fulfill will be better.As of now it doesnt look like inflammatory arthritis as most of the test they have done look negative except SGOT, SGPT and platelet

1. Do you experience pain all the time or is it more on exertion and gets better at rest

2. Do you experience night pains also?

3. Anytime you had blood in stools?

4. How do you feel in the mornings after waking up? is the pain and fatigue more or better??

5. Any history of irritability or forgetfullness recently?

6. Was your haemoglobin also low since you have been given Autrin.???

7. Was your CPK levels done( as it has not been mentioned)

DO let me know these queries.Would guide you further from here

Regards
Dr naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta (3 days later)
Sir,

I don’t experience pain all time. I cracking sound in both the knees and lower part of the feets joints on moving and bending. I feel stiffness/ pain in right Hip joint while walking very fast or try to run or try to bend inwards and outwards. I feel generally pain and stiffness in back of waist , left shoulder, neck , on the middle side of the chest but sometime all the thing is Ok . This is more on exertion but when i m busy with some work i feel better.

No i dont experience night pains.

I have no blood in stools but due to IBS the colour of stool is normal/black/brown. At present after consuming the current prescription for Austrin /folic acid/evion the stool colour is black. Is it due to medicine or any other reason

At morning pain /stiffness is more but gets reduced after walking and same applicable for fatigue.

There is irritability in my nature for last 2 years and forgetfulness increases in the present. I forget anything in the present anytime.

No my haemoglobin is always normal,.
At March 16 it was 15.5 and PT were 2.15.
In Aug 16 HB is 14.4 and PT were 1.50.
In sep 16 HB is 14.4 and PT are 1.25.
From March 15 to Nov. 15 I was taking prescription for IBS from XXXXXXX .He gave me a BIO D3 XXXXXXX {as methycoblamin , Calcium Carbonate ,omega 3 fatty acids] Vit D capsule Q 10. I felt some better in Feb 16 stomach problem again become worse and hip bone pain also arises. For hip joint pain many ortho doctors advised 10-methylcoblamin injection and 1000 mcg calcium ,NSAIDS Etc...but problem is not solved completely and they suggest me MRI OF right hip i had done 2 MRI first in XXXXXXX 16 patchy area of marrow edima in head of right femur with mild joint effusion likely ITO of hip
In 2nd MRI Sep 16 focal Td PD aft hyper intensed lesion -5*6 mm pain in mediol cortex of right femoral neck .Associated mild periosteal reaction present. Mild bone narrow edima pain in right femoral neck-possibility of time osteaid ostioma most likely . D/D stress fracture. Minimal right hip joint effusion. At same time problem of stomach problem was so worst and I was referred to PGI XXXXXXX in Immunology . Here doctor advised my test and medicine as I mentioned earlier . According to my doubts my symptoms is due to toxicity of B12 . Is it possible or my doubt?
ON March 16 my B12 was 456 and Vit D 78 and from March to sept consumed so many dozes of injections and oral dozes of B12.
I have problem of meralgia parasitica in right thigh since 12 years but it doesnt cause any difficulty for me.At present my cholesterol is 206 LDL 128 and triglycerides 111.

No CPK level want done as no one advised me for the same.
Plz tell me what is decreasing it continuously and my SGPT/SGOT was always normal but now it is abnormal Why?
Acc to you whats best for me and what can i do for the better treatment . I dont know what is the disease..PLz advice me.. Sir,


doctor
Answered by Dr. Naval Mendiratta (34 hours later)
Brief Answer:
Delayed response

Detailed Answer:
Good morning XXXXXXX

Sorry for the delayed response. Was caught up in a conference

I have gone through your results...

1. Your haemoglobin has mostly been stable. So it does rule out any pathological cause in the stomach as the problem for loose stools. Constant loose motions/constipation without much drop in Hb is in favor of irritable bowel disease

2. As for your SGOT, SGPT it is midly elevated. It can be due to fatty liver as well. But i wanted to check for CPK levels. These are muscle enzymes which can be high in muscle inflammation and cause high sgot and sgpt as well.

3. As for MRI of your hip, it is important we make a clinical diagnosis first on why we are performing it. MRI will always show a magnified image and if symptoms dont match, a person is always confused on how to take things further from here. So, I am not sure what your doctors have planned after MRI except supplements.

4. It doesnt look like Vitamin B 12 toxicity. It is a water soluble vitamin and gets excreted in urine. So that aint the cause here.

Basically we need to rule out pathological vs physiological problem. As it has been going on for a while and there is no internal organ damage, we can rule out pathological disease. Coming to physiological, it is usually due to neurotransmitters defect. It can cause lot of fatigue, irritability,, forgetfullness, disturbed sleep, headaches and upset stomach. It is a disease called FIBROMYALGIA> My diagnosis remains this in your case( although clinically I havnt examined you, but symptoms point towards it)

I would suggest you read on it .. Www. Rheumatology.org--. Patient information--> Fibromyalgia. and see if your symptoms match

Do let me know for more queries

Regards
Dr naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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Suggest treatment fro IBS and hydrocele

Brief Answer: Is it arthritis Detailed Answer: Good evening thank you for writing on health care magic Well, I have gone through your history and there are some patches which if you can fulfill will be better.As of now it doesnt look like inflammatory arthritis as most of the test they have done look negative except SGOT, SGPT and platelet 1. Do you experience pain all the time or is it more on exertion and gets better at rest 2. Do you experience night pains also? 3. Anytime you had blood in stools? 4. How do you feel in the mornings after waking up? is the pain and fatigue more or better?? 5. Any history of irritability or forgetfullness recently? 6. Was your haemoglobin also low since you have been given Autrin.??? 7. Was your CPK levels done( as it has not been mentioned) DO let me know these queries.Would guide you further from here Regards Dr naval