How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Anthony Bray, MD Your Own Question

Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6855
Experience:  14 years as clinician in the field of Family Practice
13781349
Type Your Health Question Here...
Anthony Bray, MD is online now
A new question is answered every 9 seconds

How do i tell if im malnourished.

Customer Question

How do i tell if im malnourished.
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD : Hello again,
Anthony Bray MD : This is not as easy to tell in the short term. The blood test for per albumin is one way to measure this...
Anthony Bray MD : malnoutrion could be a contributing factor to your ulcers as one example.... Your cells that constantly divide and replace themselves in the skin and GI mucosa especially may be affected....
Anthony Bray MD : your blood counts might be affected too--- may contribute to anemia for example...
Anthony Bray MD : malnotition could impact your immune function and could affect other key functions such as your clotting factors...
Anthony Bray MD : The main blood test that we use to evaluate for nutritional status is the prealbumin test as I mentioned though...
Anthony Bray MD : I hope this helps. Let me know if you have further questions and I will be happy to get back with you!
Anthony Bray MD : Best Regards,
Anthony Bray MD : Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6855
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 6 other Health Specialists are ready to help you
Customer: replied 1 year ago.
Im still having problems with eating
Customer: replied 1 year ago.
At what point do i suggest to my dr that i am gettin malnourished?
Customer: replied 1 year ago.
I think i am malnourished
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I think that you probably are as well. Raise this question with your next visit to your doctor! This could be checked and followed with time to make sure that it is corrected.

I hope this helps. Let me know if you have further questions or discussion. Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
My pcp isnt very proactive. What do i tell him to get him to care? Whats the treatment for malnourishment? I know last summer when i was suffering from eating disorder my prealbumin was low
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I am afraid that I don't have a great answer to professional apathy... I would hope that your doctor cares perhaps more than you think.

You know that good nutrition is the answer to this problem. While you are having problems tolerating much due to your ulcers healing you may want to consider a supplement such as BOOST OR ENSURE... The pudding firms if these might be more tolerable... These are designed specifically to help in this kind of problem. As you are better able to eat strive to eat three or four balanced meals per day. Take a multivitamin as well when you improve.

I hope this helps! Let me know if you have anything further !! Take care!

Anthony Bray MD
Customer: replied 1 year ago.
What exactly can i eat?
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

With your ulcer disease now I would recommend that you stick to bland diet until stronger.... Things like mashed potatoes ( other forms fine) , rice, pasta with white sauce, applesauce, bananas, breads, supplements such as the nutrient pudding ex. Boost pudding-- maybe chocolate flavored shouldn't be too bad...

Avoid hot spicy foods, peppers, onions, citrus fruits for now, tomatoes, coffee, anti- inflammatory MEDS (Tylenol ok) , and of course no alcoholic drinks.

As you tolerate initial diet then add in more foods such as vegetables peas, carrots, beans, peanut butter--- later add steadily more fruits and meats to further build up your nutrition!!

I hope this helps! Let me know if you have further questions! Best regards!!

Anthony Bray MD
Customer: replied 1 year ago.
What does prealbumin measure? My urine is very dark and has a horrible odor
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

Well albumin and prealbumin are proteins produced by the liver but they are a measure of nutrition. These will go down --- first prealbumin and later albumin will decline if you have protein/calorie Malnutrition ...

The dark urine--- is this tea colored? If this then that may indicate some blood in the urine possibly from the kidneys... Severe dehydration can harm the kidneys and even out you into renal failure which is major reason to take this problem seriously. Liver disease can produce a dark appearing urine. Dehydration produces a very concentrated urine..UTI oils be common reason for perhaps a foul smell and cloudy appearing urine..

So you may wish to get follow up today at urgent care??? Otherwise try to push fluids.. I would advise that the urine be rechecked soon!!

Thank you for your accept! I appreciate it!

Let me know if you have further concerns! Best regards!

Anthony Bray MD
Customer: replied 1 year ago.
Could harming the kidneys cause wbcs in the urine
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yes it is possible that primary disease of the kidneys could produce white cells in the urine. Usually primary disease of the kidneys has other signs though such as red cells, protein in the urine or casts being present...

I hope this helps. Let me know if you have further questions. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Do i see urgent care tomorrow?
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

Yes-- I think that would be a good idea for you. It seems to me that you need this checked out ASAP...so I think that urgent care tomorrow would be reasonable choice here...

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
My tummy hurts too
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Your stomach pain may be due to your ulcers and gastritis. These would be expected to cause stomach pain. Does this seem to fit with the pain that you have??

Let me know of this and other questions that you may have. Take Care!!

Anthony Bray MD
Customer: replied 1 year ago.
Its lower abdominal pain. I know my chest pain is probably related to the ulcers
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well you have had the diarrhea which may produce some lower abdominal pain. Does that seem to fit? Pelvic pain could be a sign of PID as you know. If it were worsening pelvic pain then this might be reason to be seen especially if accompanied by spiking fever...

Let me know if you have further details or questions. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
I dont know
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well if you feel worse by tomorrow in particular then please do be seen at urgent care at least. If better then it would probably be OK to wait to Monday if you prefer...keep a watch on the abdominal pain as well as other signs and symptoms...

I hope this is helpful. Let me know if you have further questions! Best regards!!

Anthony Bray MD
Customer: replied 1 year ago.
Do you think i just have health anxiety
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

You have legitimate problems and documented abnormalities ... So you do have health problems... You may ALSO have health anxiety but you definitely have legitimate physical issues....

I hope this helps! Take care!!

Anthony Bray MD
Customer: replied 1 year ago.
Its not in my head. I know theres something wrong with me
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I know that it is not in your head! You had abnormal endoscopy results, CBC and urinalysis -- these are definite physical problems that you are dealing with! Hang in there! I hope that you recover soon!!

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
I feel better today. No fever. So i wikl followup with my dr sometime this week. Whats the typical dose of nexium? Dr rxd me nexium 40 mg BID
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Ok , I' m glad that you feeling better today!! I agree with follow up with your doctor sometime this next week! The usual dose of Nexium is 40 mg po QD so the bid dosing is high dosing for you.

I hope this helps! Let me know if you have further questions! Best regards!

Anthony Bray MD
Customer: replied 1 year ago.
What would be the reason to do nexium twice a day
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

It is to be aggressive to treat your ulcers. The high dose does further raise the average pH of your stomach some. The dosing was due to the severity of your stomach's condition though and I would agree with this approach.

You were probably tested also for H. Pylori and I presume this was negative?? The high dose Nexium would be used with H. Pylori treatment as well as double antibiotics for two weeks...

I hope this helps. Let me know if you have further questions! Take care!!

Anthony Bray MD
Customer: replied 1 year ago.
Idont know if my biopsies were tested for h pylorinor not
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again.

I'm pretty sure that they would have been... That would be standard....as with the other results I would be sure that you get your results reported back to you...

I hope this helps! Best regards!

Anthony Bray MD
Customer: replied 1 year ago.
Im frustrated that i dont know whatscwrong sith me
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

Well you know that you have the ulcer disease and one possible cause of that would be H.pylori infection. I can't tell you at this point if the gastritis and ulcers is due to H. Pylori or other factors such as stress ... It is treatable either way. In the long run good nutrition is an important component for your GI tract to heal and stay healthy though.

I hope this helps. Let me know if you have further questions! Best regards!

Anthony Bray MD
Customer: replied 1 year ago.
Im doing my best
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I know that you are! Hang in there ! You will recover and feel well again. You are going through a bad spell right now but things will get better.

Take care,

Anthony Bray MD
Customer: replied 1 year ago.
I will look at my urine culture tomorrow and look at what it says
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Right I agree.... Checking on this result will be of key importance..

Take care,

Anthony Bray MD
Customer: replied 1 year ago.
I will look at my chart tomorrow
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

Ok well good luck with your follow up tomorrow. I hope that you continue to feel better as the botXXXXX XXXXXne though.

Take care,

Anthony Bray MD
Customer: replied 1 year ago.
Can stress make ulcers worse
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yes - definitely stress is a big factor in ulcers. I realize this factor is difficult to control though...
There may be certain steps that you can take such as saying no to too many projects or obligations... Try to give yourself good amount of "down time" or relaxation time...

I hope this helps. Take care,

Anthony Bray MD
Customer: replied 1 year ago.
I have custody of 2 teenagers, i dont get down time
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yikes! I see your point.... I don't know what to tell you exactly except to do your best! I hope that you get some help with your teens, that may help if you get more help with them...

Take care,

Anthony Bray MD
Customer: replied 1 year ago.
My bp is low. First time 76/49. Secondtime 86/57. Third time 84/53
Expert:  Anthony Bray, MD replied 1 year ago.
Hello,

That is too low and dangerous! Are you seeing your doctor today? I would advise having someone else drive at the very least. The hypotension is justified reason to go to ER ...dangers would be fainting and poor organ perfusion leading to tissue and organ damage ( kidneys for example) the numbers would be consistent with you being in shock...90/60 is usually the floor of tolerable by adults in general... The 76/49 reading is particularly alarming... The second two readings are of course closer to the floor of 90/60...

Important factors to consider would include your pulse rate as well, what your current symptoms were like--- light headed, feel faint, weakness, fever, pain , nausea???

IF BP was 80's/ 50's as a chronic low value in a thin low weight I Individual dual then this case may not be as bad--- the degree of drop from your normal baseline is also a factor to consider here...

The factors that might be contributors to this finding could include dehydration or blood loss>> hypovolemic shock // infection with your fever could be leading into septic shock as a possibility...

Your doctor needs to evaluate your big picture here very carefully--- cause of the low BP needs to be established and treatment measures need to start!! The low BP needs to be interpreted in the context of other findings such as your current feelings, physical exam and labs as needed. Your baseline BP and the course of BP over recent days is important for you!

I hope this helps! Let me know if you have further questions. Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
Lately my bp has been in the 110s/70s. This morning when i got up i was really lightheaded. I couldnt stand for long periods of time. Amd my arms felt tired. I am at work now. I dont know if i can see my dr today or not. I know that i dont feel good though
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well it does not sound to me that you should try to stay at work in your condition!!

I would advise that you leave from work and get seen today by one way or another. If your primary doctor will see you then that is fine. If you need to go to ER then don't hesitate!

I hope this helps! Let me know if you have further questions ! I will be happy to get back with you! I hope that you feel better soon! Take Care!

Anthony Bray MD
Customer: replied 1 year ago.
Just checked it again. It was 83/55
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,This is still too low....needs follow evaluation .... This at least better than the 76/49 but still uncomfortably low....How is your pulse rate?? Are you running any fever so far today?? Any black or tarry stools?? How has your fluid balance been in last 24 and 48 hours, roughly?? How is your weight ?? Is this down even further or about the same??Are you been having diarrhea and how many BM s / day ?? Vomiting or poor intake due to nausea ??How is your abdominal, pelvic and/or other pains?? Let me know on the above questions. Let know you you feel as time passes over next few days...let me know if you have further questions for me. Best regards,Anthony Bray MD
Customer: replied 1 year ago.
My pulse is 80s. Fluid intake sucks. I am not havig diarrhea been vomittig only a coulple times. Pain is still there.
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well it is reassurring to a point that your pulse remains in normal range. The fluid intake needs to improve . You want to improve oral hydration and consider that you may still need IV fluids.

I hope this helps. Take care,

Anthony Bray MD
Customer: replied 1 year ago.
How low is too low?
Customer: replied 1 year ago.
Spoke to my dr he told me to push fluids
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well as I said the 90/60 is a benchmark but this may be tolerated by some people. Low weight people would be more likely to tolerate this or slightly lower. The clinical symptoms such as dizziness are relevant.

Ok to push fluids and salt intake to try and support BP but I worry that you may not be very successful in this based on your history.

Did you get urine culture results? Any other results?

Let me know. Take care,

Anthony Bray MD
Customer: replied 1 year ago.
My dr told me my potassium is low. To eat some bananas. My crp and wbcs are normal. They did another urine culture today
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I am glad that your CBC is back to normal. I think that shows your body doing its job vs whatever infection led to the previous WBC being do high. You can eat bananas as one source of potassium. You could take an OTC supplement if you choose too...

How are you feeling now?? I hope better ...

Let me know of updates or further questions. Take care,

Anthony Bray MD
Customer: replied 1 year ago.
If i have a yeast infection down below with the fluconazole cure that? Its getting painful
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Yes fluconazole would cure a vaginal yeast infection. I hope that you feel better soon!

Take care,

Anthony Bray MD
Customer: replied 1 year ago.
How long until it works. It kinda burns down there
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

Usually about 2 days or so for that to be effective..

 

Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
Ive been on it a week
Expert:  Anthony Bray, MD replied 1 year ago.

Hi again,

 

If on it a week then I would think that other cause would be the reason for vaginitis. If known to be yeast then you could use a topical product such as Monostat...

 

I hope this helps. Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
I know its yeast. Koh was positive. But it seems to be worsening. When inwas diagnosed with yeast i had no symptoms. Niw i have burning and pain
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

I see.. then go ahead and use a topical product and it should clear this up.

 

I hope you feel better soon! Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
My bp is still too low!
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Do you feel light headed today as wel?? What is your pulse running? How do you feel in general. What is your BP running now?

 

You may need to be seen ( maybe by your doctor or maybe ER>>) Increasingly sounds to me that you may need IV fluids....Do you still have the diarhea?? How has your fluid intake been ??

 

Let me know on these and i will get back with you>> Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
Iightheaded. Pulse 56. Bp was 74/49. Had diarrhea once last night. Had 20Oz of fluid yesterday. My electrolytes where fine yesterday. I continue to have biliruben in my urine but no urobiligen. My 24 hour prelim urine culture shows >100000 cm of mixed organisms
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

The main thing is that you need to have your BP supported and stabilized. 20 ounces of fluid is not adequate...You need to push oral fluids (8 to 12 ounces every 2 hours while awake) and salt too...but at this point better be seen at ER and get IV fluids>> BP is dangerously low>>>

 

The urine sample being polymicrobial may be contaminated result.. this result itself is not much help one way or another I am afraid...more reliance on current U?A and clinical picture...

 

I hope that this helps. Let me know if you have further questions. Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
Ive been eating pretzels. And ive had 36 oz today
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Well that is a start >> how is your BP doing now??

 

Let me know>> get help if you need it!! Take Care,

 

Anthony Bray MD

Customer: replied 1 year ago.
87/53
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

Well at least that is progress in the right direction. Still not great and too low but much closer to 90/60 minimum that should be maintained... You should be OK to continue to push the fluids and salt and monitor this...

 

Let me know if you have anything further. Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.
It is what it is i guess. My pcp doesnt seem to care
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well do what you need to do to take care of yourself>> don't overly rely on your PCP especially if you feel that this doctor is being apathetic toward your care!

The improvement in your BP I think is an encouraging sign... I really felt at the BP reading 70's/ 40's that you should have gone to the ER at that point ...

Your last BP report was getting close to minimum but still dangerous >> (This should not be taken so lightly as I have seen patients go into renal failure after being severely hypotensive!! >> this was however in elderly patients with probably compromised renal blood flow...)

AT THE LEAST CONTINUE TO PUSH FLUIDS AND SALT >> let me know of your BP at this time...

Take care>>

Anthony Bray MD
Customer: replied 1 year ago.
81/55
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

That is a bit worse than last reading >> You should go to ER >> that would be safer for you>>

Take Care ,

Anthony Bray MD
Customer: replied 1 year ago.
I dont want to go to the er especially since i just saw my pcp yesterday!
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I realize that you do not want to go to ER and I realize that you probably will not go... I feel that it would be the safer option for you... I feel that I am compelled to so instruct you on this.. the prolonged low BP is concerning to me.. it seems that if you were pushing adequate salt and fluids that it should have improved and recovered over the 90/60 mark by now.. I am concerned that it may continue to drop...

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
Ifeel like you are frustrated with me
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

No don't worry about me.I'm fine. I do worry that you seem to linger so long in dangerous territory...

I wish you to get good care>> I wish you to get back on your feet with good health!!

Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
All my labs are normal so it cant be anythjng too serious
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I would agree that your WBC coming back to normal is reassuring...

Do you know what your BP normally runs? How far below your normal range are you? How do you feel? Are you feeling as though you are going to faint? Do you feel OK?? When you get up and move around is your heart racing?

These factors of how you are doing in a clinical sense would be helpful to know>>

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
Past month or so its been in the 100-110s/70s. I feel faint all the time. I dont think my heart races. When i do exert myself my chest hurts
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well continue to support your fluids and electrolytes...Gatorade, Tomato juice, soups, salty foods like your pretzels are good options that should be helpful. Continue to monitor your BP with goal to get this stable above 90/60...

I hope this helps> Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
What do i do if my bp doesnt regulate
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I would make it so that you should keep the BP greater than 80/50 or otherwise go to ER>> I would prefer that you get the BP greater than 90/60 mark as soon as reasonably possible...

I hope this helps. Take care>> I hope that you feel better and stay that way!!

Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
What do i do yo keep it elevated?
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

Push fluids and salt as I have described. If you were a hospital patient with same problem then the first thing we would do would be to bolus 500ml of normal saline...

I hope this helps. Let me know if you have further questions. Take care,

Anthony Bray MD
Customer: replied 1 year ago.
If i went to the er woukd they let my go home or admit me?
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I don't think that you are so sick currently as to require admission. You probably would still benefit from IV fluids to help you catch up your deficits. Once the deficits are caught up then your BP should then be stable. It was probably the prolonged vomiting and then the diarrhea that caused this....

I hope this helps. Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
Im sorry for repeatedly bothering you
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

You have no need to apologize!! You are fine! I'm here to answer questions!

Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
Do you know anythung about hemolytic uremic syndrome? We diagnosed a 10 year old with it today
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yes I am familiar with that diagnosis. This is associated with verotoxin >>E.coli 0157:H7 may be a cause of HUS>> elevation of BUN and creatinine, anemia, hematuria, proteinuria,

Did you have specific questions regarding this??

Anthony Bray MD
Customer: replied 1 year ago.
My dr putting me on macrobid for 10 days
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

That sounds promising. I felt that treating you for the UTI was overdue...IT did sound promising that your WBC had normalized though...

Hopefully the Macrobid will help you to clear up this UTI and you will feel better.

How is your BP doing today??

Let me know.. Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
91/58
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

OK well that is at least better than what it was! I am relieved that it is better, still fairly low but at least systolic >90 mark...

Let me know if you have further questions. I hope that you are feeling better and continue to improve! Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
I went to the bathroom #2. Very loose i noticed a large amount if blood when wiping
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

More of a bloody diarrhea would you say or bright red blood as if from a hemorrhoid??

Are you having much in the way of abdominal cramping?

Any recurrence of fever or chills??

Were you anemic with recent blood work or was that normal??

Let me know and I will get right back with you!

Anthony Bray MD
Customer: replied 1 year ago.
Diarrhea has some blood, but more bright red blood. Have abdominal pain. No fevers but have chills. Hgb 12.2
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

How much blood would you estimate?? If a couple of tablespoons then that might be consistent with hemorrhoidal bleeding.. Do you have any history of hemorrhoids or anal fissure??

Has the bleeding apparently stopped or is this ongoing?? If ongoing then again you may need to go to ER....

BP doing OK or still very low?? Heart racing or normal?? Light headed or back toward normal in this regard?

At the very least it seems that you will need to closely monitor further bleeding... if this is ongoing then you should be seen and evaluated...

I hope this helps. Let me know.. Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
I dont know how much. Ive never had an issue with hemorrhoids or fissures. I havent gone to the
Bathroom since. Idk what my bp is
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well on the one hand if you just had blood on toilet paper one or two times then this would not concern me as much as blood filled toilet... esp if too dark to see through the water >> that would indicate more blood...

If you have a bloody diarrhea then it may be an ongoing type.. If you have further abdominal pain, cramping, fever, then these would be potentially concerning signs....

So I would advise monitoring for concerning ongoing bleeding or other signs of concern at this point forward.. don't hesitate to get help and go to ER IF you have such signs of concern. Hopefully this is just from some hemorrhoid > perhaps as this would be the most common cause of mild rectal bleeding ..

I hope this helps. Let me know if you have further questions or other >>>

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.
All i know if my stomach hurts
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

What part of your stomach hurts? How severely? Does it hurt too much for you to be able to sleep? If YES >>Then I would advise that you consider going to ER...

At least monitor for further bleeding or other signs of concern...

I hope this helps. Let me know if you have further questions or issues.. Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
Its my lower left side. It hurts to the point of wanting the vomit. Im still working
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

The location of LLQ is common for diverticulitis as one possible cause BUT at your age I would not expect that cause to be likely> Still it may localize the problem as likely involving the descending colon or sigmoid colon or rectum as possible areas of concern.

I would worry about colitis as possible. Inflammatory bowel disease as possible cause of this. C. diff should be ruled out I think...

If stable then I think you should consult a gastroenterologist most ideally...

If ongoing bleeding of any volume of blood loss then don't hesitate to seek help at the ER>>

I hope this helps! I hope that you feel better soon! Best Regards,

Anthony Bray MD

PS >> if you would please start a new thread soon as this one has grown greater than 50 Q and A's again... Thank you>>
Customer: replied 1 year ago.
Sorry that it grew to more than 50 questions. Ive had colitis in the past
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

You have had colitis in the past? Well it seems to be a recurrence here.. Do you know the cause of the past colitis?? (inflammatory or infectious??)

You will need follow up on this it seems. I would advise that you plan follow up with your PCP >> Gastroenterologist>>

I hope this helps. Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
They did a ct which showed inflammation. Gave me cipro and flagyl and did a colonoscopy 2 weeks later which was normal. My gi dr is gone until 6/6
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I see>> How long ago was that episode?? It sounds that you are likely to have a similar scenario>> I would recommend that you at least follow up with your PCP ASAP >> later GI when you are able>> IT may be that he is part of a group and perhaps a partner in the practice might see you??

If you have a colitis causing lower GI bleeding now then that is not something that you want to delay treatment of...the macrobid alone would not likely be a cure to that...


I hope this helps. Let me know if you have further questions. Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
I cant afford to see my pcp or my gi dr now
Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

I don't see how you can afford to go forward without treating this problem!!

It does not seem like the sort of thing that will get better on its own... it could I suppose but the danger for you is significant I fear with this condition!!

Take care and be careful!!

Anthony Bray MD
Customer: replied 1 year ago.
Im still
Having diarrhea; however, it is not noticibly bloody anymore
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well it is good that it is no longer a bloody diarrhea. I hope that you recover and feel better,

Take Care,

Anthony Bray MD
Customer: replied 1 year ago.
Since yesterday whenever i est i get bad abdominal pain and diarrhea within 30-60 mins
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Please clarify --- are you having abdominal pain and diarrhea now?? Has it improved , gotten worse or about the same vs yesterday??

Let me know and I'll get back with you! Please start a new question thread soon...

Take care,

Anthony Bray MD
Customer: replied 1 year ago.
Diarrhea abdominal pain after eatting. No blood though
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I am reassured to a fair extent that it is no longer bloody diarrhea. I think that it may be prudent for you to consider having it worked up further such as with stool studies since you have had the history if colitis, LLQ pain and some bloody diarrhea...if this resolves within a few days and you feel better then this would not seem to be necessary---hopefully that will be the case for you !!

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
So give it through the weekend?
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

That is ok so long as this is just mild case diarrhea -- yes . BUT if you should have severe abdominal pain or bleeding or a high volume severe diarrhea ( risk if recurrent dehydration and hypotension) then you might need to be seen...

You may benefit to try Pepto Bismol or kaopectate for the diarrhea. This has anti- diarrhea benefit as well as anti- microbial ... One dose after each loose stool - max seven doses per day - max five days-- chalky black discoloration of stool is expected with these...

I hope this helps. Please start a new thread of you have further questions. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
I didnt think people with ulcers could take pepto
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

It is a salicylate and you have a good point actually --/ best not use that product due to your ulcers!! I agree....

Take care,

Anthony Bray MD
Customer: replied 1 year ago.

Im seeing a general surgeon on wednesday. I saw suppose to see him back in december for rectal bleeding to rule out a fistula but i kept rescheduling it
Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Well that will be useful-- many general surgeons will also perform colonoscopies.... This may be a useful avenue of further diagnosis and treatment for you...

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.
its just awkward since i work with the surgeons sometimes
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well that is understandable that it may feel awkward but you know that this diagnostic test is in no way personal to the surgeon.... It is up to you as your comfort in having a given professional do this procedure is completely up to you. You may choose to wait and have your gastroenterologist repeat this procedure... It seems to me that it would be perhaps some advantage in time to have the surgeon perform the colonoscopy. This would seem to probably expedite the diagnosis --- if this should be an ongoing problem of course.

Take care-- please start new thread if you should have further questions---

Anthony Bray MD

Customer: replied 1 year ago.
Very last thing. Thensurgeon would
Be doing and anoscopy
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yes the surgeon could opt to perform an anoscopy. This may identify possible causes of bleeding such as hemorrhoids or anal fissure. If the anoscopy identified a cause of the bleeding then this might make a colonoscopy unnecessary. The anoscopy is a simple in office procedure. If you had ongoing symptoms suggestive of colitis then a colonoscopy may be needed still even after anoscopy.

I hope this helps. I request additional payment at this time please. Thank you and best regards,

Anthony Bray MD
Customer: replied 1 year ago.
Will a 8$ tip be ok
Expert:  Anthony Bray, MD replied 1 year ago.
Hello again--- yes that would be much appreciated!

Thank you! Take care!

Anthony Bray MD
Customer: replied 1 year ago.
Dr bray. How long does it take for macobid to work. I started it on wednesday. But my urine stinks and is very cloudy
Expert:  Anthony Bray, MD replied 1 year ago.
This thread is now too long and is closed.

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery