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    What does this urinalysis report indicate?

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Posted on Wed, 9 Aug 2017 in Brain and Spine
Question: Unknown diagnosis.
Symptoms:
inability to sleep through the night. chronic constipation. hot flashes
increased thirst agitation. easier to increase temper. decreased ability to concentrate/remember. Decreased libido Exhaustion. Slight facial and feet swelling. Increased anxiety. Depression.
Occasional Blood in semen post ejaculation Increased feeling of stress. Loss of interest in activities
Recent admission to the hospital with enteritis of unknown cause. On levaquin and flagyl. Recent labs done, all within normal limits. Normal vital signs, testosterone level, thyroid level, cortisol level. Negative for common bacteria. Slightly elevated WBC possibly r/t enteritis. Unknown if bacterial or viral cause.
What might possibly be the cause of the symptoms above? Symptoms started about age 27. Patient is male age 36.
doctor
Answered by Dr. Uday Nath Sahoo 2 hours later
Brief Answer:
Need psychological evaluation

Detailed Answer:
Hi,

Thanks for your question on HealthcareMagic

I do understand your concern & checked your report

With such a presentation in my clinic, I would first rule out panic attack and for it you need a psychological evaluation by a psychiatrist to confirm it. If confirmed you may be advised psychotherapy and regarding medication to prevent it you can discuss [fluoxetine]with your doctor and to prevent anxiety you need regular exercises.

Regarding blood in semen rule out inflammatory prostatitis if no infection and to confirm it you need a physical exam and an ultrasound examination and if confirmed alpha blocker can be tried.

Hope that helps
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Uday Nath Sahoo 8 hours later
hello,

I understand the reasoning for the panic attack evaluation however this has been an ongoing issue for 9 years now. wouldn't that be an extraneous amount of time for the symptoms to continue?

Regular exercise has already been apart of daily routine due to the profession of the patient.

Alpha blockers (finesteride) is potentially what sparked all these symptoms so the patient is not eager to enter back into an aloha blocker. The patient believes has looked into the Post Finesteride Syndrome Foundation (there is a website online postfinesteridesyndromefoundation.org) and has found many of his symptoms correlate with this. Do you think this could be the cause, and if so, how would we go about treating this?

Thank you
doctor
Answered by Dr. Uday Nath Sahoo 14 hours later
Brief Answer:
Detail evaluation

Detailed Answer:
Hi,

Thanks for your follow up query

“As” per your query is concerned he needs psychological evaluation to confirm it because due to over stress it can happen so he needs treatment for it first. And regarding time limit I may say that there is no time limit for it.

Secondly regarding blood in semen do check it clinically first before starting any treatments. Do an ultrasound, PSA test and quantiferon tb gold test.If already done let me know the result.

You can add a fiber supplement or any laxative at bed time for chronic constipation.

Regarding alpha blocker as you mentioned is not a cause at all you can use [doxazosin] 1 mg at bed time if inflammation in prostate present.

Hope that helps

Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Uday Nath Sahoo

General & Family Physician

Practicing since :1969

Answered : 2462 Questions

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