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Ill try to make this short, but its complicated. In Nov 2011

 
Anthony Bray MD's Avatar
  • Answered by:Anthony Bray MD
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Customer Question

Ill try to make this short, but its complicated. In Nov 2011 my appendix ruptured and I was in the ER for 10 days, and loaded with antibiotics. Fast forward 6 months. I know now that my good and bad bacteria was wiped out by the broad spectrum antibiotics. Im now dealing with Candidiasis. Symptoms include small intestinal pain and tenderness, allergies to food, painful gas and bloating, inability to evacuate my bowls without taking milk of magnesia. My brain is cloudy, my wit is noticeably decreased and ill forget a task while walking to another room to do it. Can’t sleep, headaches, and fatigued.

Recently, I started getting what I thought was jock itch, and OTC anti-fungal worked at first, but stopped. It came back, I went to the doctor and was given 150mgs of Fluconazole, 1 a day for 14 days and Clotrimazole 1% cream. It worked, but i ran out and it came back, worse. Back to Dr, another refill of Fluconazole. This visit the doctor told me it was a Candida yeast infection. I take a Probiotic with many strains in it, digestive enzymes, and the Fluconozole (my third course). And Vitamin D.

I’m on a diet and have removed foods that have been known to feed Candida. Was 225 and very fit last year, now im 210 with an extended stomach. I have read of information and know how to do research. There has been conflicting data everywhere. Ive read that Candida will become resistant to any medication after 5 days. That it will burrow into intestinal walls and grows root like structures to spread, also causing intestinal impurity (sp?).

I’ve had insurance for most of my life, but do not now. I can’t afford to see a GI specialist. Systematic Candidiasis can be deadly. Since we all have it, testing positive for it is not enough to get treated at the ER. I have not heard of any test to confirm that one has ‘to much’. Im hoping you can help. I’ve been suffering on a daily basis for 8 months. Id try anything at this point.

 

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Person's Gender: Male
Person's Age: 32

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Submitted: 240 days and 15 hours ago.
Category: Health
Value: $30
Status: CLOSED

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Expert:  Anthony Bray MD replied 240 days and 14 hours ago.


Anthony Bray MD :

Hello!

Anthony Bray MD :

Usually Candida species are not very virulent pathogens. The worst cases of espohagigits in immunocompromized patients usually respond to thirty day treatment regimens....

Anthony Bray MD :

It sounds that reasonable steps have been tried in your case including the rounds of fluconazole and taking Probiotics.

Anthony Bray MD :

I woyuld of course advise to continue the probiotics...

Customer :

Ive been told that

Customer :

and have

Anthony Bray MD :

I would suggest that you might consult a gastroenterologist to have your stool checked for other pathogens>>I would worry that you might have contracted C.diff for example which is much more difficult to treat...

Customer :

my concern is the painful swelling of my - i dont know - under the belly button but above the underwear line - section.

Anthony Bray MD :

Stool cultures and testing for parasites, ova and yeast would be a possible avenue to anwer this question....

Customer :

yes, i saw a GI specilist, thats a test he wanted to do

Anthony Bray MD :

Do you have constipation or diarrhea or other GI type changes??

Anthony Bray MD :

They also test for the C. Diff toxin at the same time....

Anthony Bray MD :

Did this testing get done?

Customer :

but he also wanted to test for SIBO, lactose intolerance, and something else all at the same time. I had no insurance, the bill was more then i could come up with.

Customer :

yes, i dont go as often as I used to, but when I do, its not constipation

Customer :

its not hard

Customer :

its normal

Anthony Bray MD :

I see, well the most basic testing could be ordered by your primary caare doctor and these would include cultures, parasities, ova and the C.diff toxin....

Anthony Bray MD :

Do you have abdominal pain?

Customer :

feels like the mobility in my small intestines has been effected

Customer :

yes

Anthony Bray MD :

It is possible. You could have an overgrowth of the wrong type of bacteria as a possibility.

Customer :

And my normal doc can order the tests, i dont have to see a GI doc?

Anthony Bray MD :

An upper GI and small bowel follow through would be able to at least tell if there was certain types of disease affecting the small bowel.

Customer :

General Practitioner costs $65 for the visit, the GI doc costs $500. What do u mean by follow through?

Anthony Bray MD :

Yes your normal doc can order many of the tests that you may need. Not do a colonoscopy or cetain tests but most of the routine tests he/she can order >Yes

Anthony Bray MD :

Small bowel follow through refers to the barium contrast being followed through the small bowel....

Anthony Bray MD :

Right , I inderstand that your general practioner is much less expensive and to get as much testing as is practical through him/her would be best for you...

Customer :

You mentioned tests for cultures, parasites, ova and the C.diff toxins. That my doc can order. In laymens terms, what do I ask her so that she knows to perform these tests? She has my blood checked after the surgery, but thats it.

Anthony Bray MD :

Yes I would address her with your ongoing symptoms and specifically ask her about these tests. Let her know your reluctance to see a GI specialist as she might have an impulse to go in that direction....

Anthony Bray MD :

But YES she can order all of the above tests>>>>

Customer :

And these test will tell her if I have a disease in my GI track? Do the tests have anything to do with the fungal/yeast infection?

Anthony Bray MD :

Yes that would be included

Anthony Bray MD :

Now trace amounts of a yeast would not but if this were predominant which it should NOT be then it would....

Customer :

Ive heard that leaving a Candida infection untreated could cause it to get in ur blood and become Systemic

Customer :

and that could kill you.

Customer :

but nothing gave me the info on how long that would take, if its an extremely unliky even to occur

Anthony Bray MD :

That is rare. Candida is ubiquitous>>it is always around us. Only immunocompromised people usually have any major trouble in fighting this organism....

Anthony Bray MD :

It is very unlikley to become a major pathogen in humans....

Anthony Bray MD :

The antibiotics treatment can alter the GI organisms and make this become a problem but it usually will transition back to normal bacteria in time....

Customer :

Im sexualy active, and have been tested regularly, so I dont think i have aids, but the last doc I saw took one look at my scar from the appendix removal and said that it should have healded by now, but it was still red, indicating that it was not fully healed, He said that was a sign that my immune system was weakened, and i needed to get that treated

Anthony Bray MD :

It is generally the very ill such as cancer patients or AIDS patients that would be at risk for sepsis (yeast in the blood) from Candida...

Customer :

good to know.

Anthony Bray MD :

If you should happen to be diabetic then that could delay healing and make you somewhat more susceptible to yeast as well...

Customer :

are symptoms like this normal after 8 months? A fried had his removed, was out of the ER in 3 days, and never suffered issues.

Customer :

I am not

Customer :

diabetic

Anthony Bray MD :

No I would not expect that you would still be having problems after 8 months >that is an unexpected result....

Customer :

I was told to start taking vitamin B by the last doc, yet i read online that taking vitamins could actually help the yeast, instead of ur immune systoms. I know better to believe everything i read online, but this doctor has a pretty good explaination why

Anthony Bray MD :

I think you would be fine to take vitamins if you want.

Anthony Bray MD :

The probiotics I also agree with....

Customer :

if it will help heal me, I will take anything.

Anthony Bray MD :

Well mostly I recommend the testeing that I mentioned as I suspect that something other than yeast may be your culprit...

Customer :

because of the tender and swollen abdomen

Customer :

?

Anthony Bray MD :

Well you have been treated three times for yeast and still have problems and it sounds that some key tests for your symptoms have not yet been run. That is what I am basing my suspicion on....

Customer :

Would u say that Candidais not an issue, or that I have something in addition to it?

Customer :

that is sound logic

Anthony Bray MD :

Well it is possible that candidiasis is an issue but I would look to the stool studies to see what exactly is the issue. You might have C.diff. You might have an overgrowth of some bacteria in a pocket of the small intestine. You may have a parasitic infection such as Giardia which would not have been touched by anything that you have taken so far...

Customer :

And the stoll study can be ordered by my GP doc??! I was told that only GI docs did that

Customer :

stool*

Anthony Bray MD :

No your primary care doc can order these tests. There are collected and run by a lab and the results sent to the ordering doc,\

Customer :

I give them a sample, they use it to determine what bacteria is in me, and what is lacking, which helps pinpoint what I need to be prescribed to balance out my intestinal flora?

Customer :

thats a question, as I dont know how it works

Anthony Bray MD :

Typically we would order a stool sample in a set of three samples. This is to increase the detection of ova and parasites. They do not try and culture the common normal flora such as nornmal E.coli but try to isolate and culture pathogens. The extent of the study does depend on exacrtly what is ordered. The MD has to order the C.diff toxin test for this to be run for example....

Customer :

ok, i got it. U get a 'very happy face' rating. I have one more question, then we should be done

Anthony Bray MD :

OK

Customer :

Im concerned about intestinal permeability and SIBO. The former because Ive read that Candidacan grow root like structures, and poke holes in ur small intestines. Obviously, this would be bad, as I dont want other things escaping into my body. The latter (SIBO) is a concern because my symptoms match up. With the good bacteria that stops others from entering my small intestines all gone, the door was wide open. SIBO causes an extended stomach - and other symptoms - but I definatly have an extended stomach. Ive lost 15lbs, and I can fit into pants that where tight before. Should I be concerned about them?

Customer :

sorry, i CANT fit into pants that I could before I lost the weight

Anthony Bray MD :

I would doubt that your intestinal wall would be compromised as you would be VERY ill.

Customer :

thats a relief

Anthony Bray MD :

Your doctor should of course examine you as part of her evaulation and if though needed then you could be evaluated with an upper GI and small bowel follow through >>this is where you swallow barium contrast and it is followed into the GI tract...

Anthony Bray MD :

I hope that this has been helpful for you. Let me know if you have further questions!

Customer :

Its more then I hope for, if you cant think of anything else, then im good. The GI follow through you just mentioned, is that a procedure the dr would order, that id have to go to a hospital for?

Anthony Bray MD :

Yes your doctor would order it and then typically you go to the hospital radiology department where the test is run....

Customer :

Thank you Doctor. Is there a way I can add you as a favorite, in case I have another question in the future?

Customer :

or is it luck of the draw?

Anthony Bray MD :

Yes you can always address your question to >Dr. Bray or look up my profile on this site and then type your question in the box on that page....

Customer :

ok, thanx. Have a nice day.

Anthony Bray MD :

Thank you and you as well!! Take Care!!

Expert TypeDoctor
Category: Health
Pos. Feedback: 99.0 %
Accepts: 2399
Answered: 8/12/2012

Experience: 14 years as clinician in the field of Family Practice

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