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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34998
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have been snorting ketamine for 7 years. Earlier this year

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I have been snorting ketamine for 7 years. Earlier this year I had an operation to repair a hole in my septum. It has since perforated again. Within the past year I have noticed significant changes to my body. Recently I have been having lots of bad problems. About a month ago I snorted a line and it felt like it hit my left eardrum and every time I have took a line since it has been painful. My neck feels constantly inflamed and the glands have been a lot larger than usual. I have also been having sharp pains in the area between my genitals and anus and pain when urinating. I also have stomach cramps and pains in my liver. Whenever I go to see a GP they just take a wild guess rather than do tests and my health problems never seem to get resolved. What should I do?
I am Dr. Arun and will be helping you today.

Do you have ear discharge, known allergies?
Apart from ultrasound, were any blood work performed?
Do you have bloating, gas, acid reflux, heartburn, constipation/diarrhea, indigestion?
Are you anxious / anxiety issue?
Customer: replied 3 years ago.

I have no ear discharge. The last time i had blood taken was in July and it came back fine but the pains in my body feel worse. I do often feel bloated and get heartburn. I also get a lot of wind. I pass wind more than 15 times a day. I do feel anxious as a result of constant misdiagnosis from the GP's in my local doctors. I have had tests blood tests before and nothing has ever shown up but the problems are still there. I havent been in yet about the problem with my ear and throat.

Thanks for the further details.

For heartburn / acid reflux (GERD), following would be helpful; apart from antacids and acid blockers which are available over the counter.

A. Herbs;

1) Cranberry
2) Peppermint

B. Homeopathy

1) Nux Vomica
2) Pulsatilla

C. Nutrition and supplements;

1) Multivitamin; vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
2) Probiotic supplement
3) Omega 3 fatty acid
4) Avoid; cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
5) Also avoid; white breads, pastas, and especially sugar, red meats,
6) Eat lean meats, cold water fish, tofu, beans, olive oil.

The investigations to confirm for the acid reflux / hiatal hernia which causes heartburn are;

1) Upper gastrointestinal endoscopy (camera exam).
2) Barium swallow study.

The reasons for excessive wind / intestinal gas formation can be;

1) excessive air swallowing.

Anxious people swallow air when they are stressed or anxiety supervenes.

2) increased intraluminal (inside the intestine) production from mal absorbed (improperly absorbed) nutrients,

3) decreased gas absorption due to some pathological condition of intestines like diverticulitis

4) expansion of intestinal gas due to changes in atmospheric pressure

A solitary reason or combination can be responsible for the excessive gas.

Following may help you;

1) Avoid

a) Cabbage

b) Beer

c) Legumes

d) Cheese

e) Beans

2) This may help;

a) Bismuth subsalicylate

b) Activated charcoal

c) Simethicone; (Maalox, Mylanta); Simethicone causes gas bubbles to break up.

d) Beano; contains an enzyme (alpha-galactosidase), which helps to breakdown certain complex carbohydrates.

All are available without prescription.

Avoid foods that appear to aggravate symptoms. These may include milk and dairy products, certain fruits or vegetables, whole grains, artificial sweeteners etc. But this is based on the personal observation for the aggravating food.

3) Investigations by your physician;

a) Healthy people pass gas up to 15 times per day. If the frequency of passage of flatus is more than 20 times per day, gas chromatographic analysis of flatus collected via a rectal tube can differentiate air swallowing (which is nitrogen predominantly) from intestinal production of gas (which is hydrogen and carbon dioxide).

b) Colonic transit time.

Discontinue the following if you do them;

1) gum chewing,

2) smoking,

3) drinking carbonated beverages, and

4) gulping food and liquids.

The gas formation and mild discomfort in your age would need to look for the following causes also;

1) Gallbladder disease (gallstones)

2) Irritable bowel syndrome

3) Diverticulitis

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

I hope that this information is helpful. If you need further information, please just send me a reply asking for clarification. Once you are satisfied, I hope you will enter a positive rating so that I will be credited for assisting you. Thanks again for using this service. Your business is appreciated.

Customer: replied 3 years ago.

Thanks for the information. I was hoping you might be able to help me more with the pains in my urinary tract and bladder as a result of ketamine abuse. Also i have been blowing what looks like small strips of skin or soft tissue out of my nose and coughing them up when i sniff hard to clear my nose.

You are very welcome.

The urinary symptoms need an evaluation by a urologist for the bladder muscle disorder which are assessed by following;

1) Uroflowmetry
2) Video urodynamics.

The nose symptoms of small strips of skin or soft tissue out of nose and coughing them up sniffing hard to clear nose can be due to;

1) Allergies and ketamine abuse.
2) Acid reflux which causes reflux laryngitis and sinusitis.

Following investigations may be able to confirm it;

1) Barium esophagography

2) Ambulatory 24-hour pharyngoesophageal pH monitoring

3) ENT specialist exam

Following measures are helpful:

1) Small 5-6 meals a day.

2) Last meal should be eaten 3 hours before lying down.

3) Avoid; fried or fatty foods, chocolate, peppermint, alcohol, coffee, carbonated beverages, citrus fruits or juices, tomato sauce, ketchup, mustard, vinegar.

4) Eat slowly so air is not swallowed.

5) Lose weight if obese or overweight.

6) Elevate the head of the bed by 6 inches.

7) Avoid tight clothing.

8) Stop smoking, if you do.

You may need to repeat your general blood tests like complete blood counts and metabolic profile which includes liver function tests. These may come normal in first screening but later may reveal some diagnostic information after an interval.

It is privilege assisting you.
Dr. Arun Phophalia and 3 other Health Specialists are ready to help you

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