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How do i tell if im malnourished.

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How do i tell if im malnourished.
Submitted: 4 years ago.Category: Health
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Answered in 2 minutes by:
5/18/2013
Health Professional: Anthony Bray, MD, Doctor replied 4 years ago
Anthony Bray, MD
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Satisfied Customers: 10,341
Experience: 14 years as clinician in the field of Family Practice
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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
Category: Health
Satisfied Customers: 10,341
Experience: 14 years as clinician in the field of Family Practice
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Customer reply replied 4 years ago
Im still having problems with eating
Customer reply replied 4 years ago
At what point do i suggest to my dr that i am gettin malnourished?
Customer reply replied 4 years ago
I think i am malnourished
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
What exactly can i eat?
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
What does prealbumin measure? My urine is very dark and has a horrible odor
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Could harming the kidneys cause wbcs in the urine
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Do i see urgent care tomorrow?
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
My tummy hurts too
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Its lower abdominal pain. I know my chest pain is probably related to the ulcers
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
I dont know
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Do you think i just have health anxiety
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Its not in my head. I know theres something wrong with me
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
What would be the reason to do nexium twice a day
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Idont know if my biopsies were tested for h pylorinor not
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Im frustrated that i dont know whatscwrong sith me
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Im doing my best
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
I will look at my urine culture tomorrow and look at what it says
Health Professional: Anthony Bray, MD, Doctor replied 4 years ago
Hello again,
Right I agree.... Checking on this result will be of key importance..
Take care,
Anthony Bray MD
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Customer reply replied 4 years ago
I will look at my chart tomorrow
Health Professional: Anthony Bray, MD, Doctor replied 4 years ago
Hi again,
Ok well good luck with your follow up tomorrow. I hope that you continue to feel better as the bot***** *****ne though.
Take care,
Anthony Bray MD
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Customer reply replied 4 years ago
Can stress make ulcers worse
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
I have custody of 2 teenagers, i dont get down time
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
My bp is low. First time 76/49. Secondtime 86/57. Third time 84/53
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Just checked it again. It was 83/55
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
My pulse is 80s. Fluid intake sucks. I am not havig diarrhea been vomittig only a coulple times. Pain is still there.
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
How low is too low?
Customer reply replied 4 years ago
Spoke to my dr he told me to push fluids
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
If i have a yeast infection down below with the fluconazole cure that? Its getting painful
Health Professional: Anthony Bray, MD, Doctor replied 4 years ago
Hello!
Yes fluconazole would cure a vaginal yeast infection. I hope that you feel better soon!
Take care,
Anthony Bray MD
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Customer reply replied 4 years ago
How long until it works. It kinda burns down there
Health Professional: Anthony Bray, MD, Doctor replied 4 years ago

Hi again,

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

Take Care,

Anthony Bray MD

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Customer reply replied 4 years ago
Ive been on it a week
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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

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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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

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Customer reply replied 4 years ago
My bp is still too low!
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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

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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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

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Customer reply replied 4 years ago
Ive been eating pretzels. And ive had 36 oz today
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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

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Customer reply replied 4 years ago
87/53
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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

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Customer reply replied 4 years ago
It is what it is i guess. My pcp doesnt seem to care
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
81/55
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
I dont want to go to the er especially since i just saw my pcp yesterday!
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Ifeel like you are frustrated with me
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
All my labs are normal so it cant be anythjng too serious
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
What do i do if my bp doesnt regulate
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
What do i do yo keep it elevated?
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
If i went to the er woukd they let my go home or admit me?
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Im sorry for repeatedly bothering you
Health Professional: Anthony Bray, MD, Doctor replied 4 years ago
Hi again,
You have no need to apologize!! You are fine! I'm here to answer questions!
Take Care,
Anthony Bray MD
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Customer reply replied 4 years ago
Do you know anythung about hemolytic uremic syndrome? We diagnosed a 10 year old with it today
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
My dr putting me on macrobid for 10 days
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
91/58
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
I went to the bathroom #2. Very loose i noticed a large amount if blood when wiping
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Diarrhea has some blood, but more bright red blood. Have abdominal pain. No fevers but have chills. Hgb 12.2
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
All i know if my stomach hurts
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Its my lower left side. It hurts to the point of wanting the vomit. Im still working
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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>>
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Customer reply replied 4 years ago
Sorry that it grew to more than 50 questions. Ive had colitis in the past
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
I cant afford to see my pcp or my gi dr now
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Im still
Having diarrhea; however, it is not noticibly bloody anymore
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Since yesterday whenever i est i get bad abdominal pain and diarrhea within 30-60 mins
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Diarrhea abdominal pain after eatting. No blood though
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
give it through the weekend?
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
I didnt think people with ulcers could take pepto
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
its just awkward since i work with the surgeons sometimes
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Very last thing. Thensurgeon would
Be doing and anoscopy
Health Professional: Anthony Bray, MD, Doctor replied 4 years 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
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Customer reply replied 4 years ago
Will a 8$ tip be ok
Health Professional: Anthony Bray, MD, Doctor replied 4 years ago
Hello again--- yes that would be much appreciated!
Thank you! Take care!
Anthony Bray MD
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Customer reply replied 4 years 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
Health Professional: Anthony Bray, MD, Doctor replied 4 years ago
This thread is now too long and is closed.
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