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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Cough, Yellow Stools, White Tongue. Hisory Of Duodenal Bleeding And Edema At The Duodenum Entrance. Concerned

Hi, I am a 29 year old male with duodenal bleeding history (twice - the first, 7 years ago, the second 2 year ago - not very serious). Last endoscopy conducted in October 2011 found some edema and deformation at the duodenum entrance and a little bit of h. pylori. They were treated with Nexium and antibiotics. Since January this year I have had some yellow stools, particularly when I am stressed and have excessive coffee/tea consumption. This was added with a white coating on tongue with furs, and a little bit of cough. The front part sometimes clears but the back is persistent and have some bumps. I got tested for Candida, HIV, full blood test, parasites: all came back negative and normal. Last three four days I have had some acid reflux, so the GP put me back on Nexium again. However, the GP couldn't spot anything as yet; I am concerned if this could be a major problem with the duodenum, or the gallbladder. Thank you.
Thu, 18 Apr 2013
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Gastroenterologist,  's  Response
Hello, hastinger,
Thank you for your quiery. You have had recurrent duodenal ulcers.
You have been treated appropriately with a PPI, Nexium. You were
also tested and treated for H.Pylori which is also very appropriate.
There are a number of cases where H.Pylori can come back even
after successful therapy. I would like you to be re-tested for the
same. You can have a H.Pylori stool antigen test or a breath test.
The one condition that causes recurrent ulcers or multiple ulcers
is called "Zollinger-Ellison Syndrome". This is associated with a
tumor in the pancreas that produces gastrin which causes excess
acid and ulcers.
The way to diagnose this is by doing Fasting Gastrin levels in the
blood at least on three separate occasions. Increased level of
"Chromogranin A is a marker for these type of tumors. There
are also Secretin stimulation test and acid measurement that
can help with the diagnosis. Get your blood calcium levels checked.
I hope you can discuss these with your doctor.
I wish you well.
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Cardiologist,  Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

H.pylori can be eradicated easily...

Stress, abuse of Non Steroidal Anti Inflammatory Drugs, gastrin secreting tumours - and so on should be evaluated if the ulcer is recurrent. Smoking? A gastro-enterologist must see...

That may not be candida - there are huge papillae especially in the back of tongue, which can look like that. Get it confirmed by your doctor...


Take care
Wishing speedy recovery
God bless
Good luck
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Cough, Yellow Stools, White Tongue. Hisory Of Duodenal Bleeding And Edema At The Duodenum Entrance. Concerned

Hello, hastinger, Thank you for your quiery. You have had recurrent duodenal ulcers. You have been treated appropriately with a PPI, Nexium. You were also tested and treated for H.Pylori which is also very appropriate. There are a number of cases where H.Pylori can come back even after successful therapy. I would like you to be re-tested for the same. You can have a H.Pylori stool antigen test or a breath test. The one condition that causes recurrent ulcers or multiple ulcers is called Zollinger-Ellison Syndrome . This is associated with a tumor in the pancreas that produces gastrin which causes excess acid and ulcers. The way to diagnose this is by doing Fasting Gastrin levels in the blood at least on three separate occasions. Increased level of Chromogranin A is a marker for these type of tumors. There are also Secretin stimulation test and acid measurement that can help with the diagnosis. Get your blood calcium levels checked. I hope you can discuss these with your doctor. I wish you well.