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Old Guy Medical Advice ?
Posted by: chopper
Date: December 06, 2019 05:04PM
My 70 year old male friend has developed a stomach issue he and his Dr can't seem to diagnose, much less fix. Pretty healthy for 70. Never smoked, not overweight, low stress life, T2 he controls with diet and metformanin (sic). Hip replacement two years ago. All has been well.

About six months ago developed he got a low rumbling digestive system, loose etc and started feeling like low level flu. Was not around anyone ill. Just not feeling well, and out of the blue developed acid reflux at night. Never had it before.

His dad died at 61 from some kind of stomach cancer... so he's trying to not freak out but I can tell he's concerned and this is a guy who is very laid back.

Doctor visits thus far:

Tried no Metformanin for a few weeks. No change.

Round of antibiotics. No change.

Stuck the camera down his throat for a visual. Everything looked good.

Went up the exit with a camera, no change since his last colonoscopy.

He's going to a small town Dr he trusts. I get the sense the Dr has kind of thrown his hands up at this point. My immediate advice is "second opinion" but he does not want to have to do the inlet and exit cams again with a new Dr who will probably order the same tests.

Any suggestions of tests to ask for, treatments or general advice?
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Re: Old Guy Medical Advice ?
Posted by: Todd's keyboard
Date: December 06, 2019 05:20PM
If my understanding of Dr. Steven R. Gundry is correct, much of human health and illness begins in the gut. The things we eat are either good or bad for us.

A doctor friend who specializes in nutrition is going through Dr. Gundry's books right now. My friend says that Dr. Gundry is either a huge charlatan or deserves to win a Nobel Prize for his groundbreaking ideas in nutrition.

The concern that my friend and I share is that Dr. Gundry also sells his own, labeled supplement products.

Here are the works of Dr. Gundry carried by the Seattle Public Library.

Wish your friend the best.

Todd's wishes-it-were-lectin-free keyboard
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Re: Old Guy Medical Advice ?
Posted by: Drew
Date: December 06, 2019 05:32PM
If he's concerned, by all means a second opinion at a well respected institution is the next step. The exams might not be pleasant, but neither is the worse alternative. My experience is wife with ovarian cancer. I also help non-native English speaking medical researchers publish their research in English journals and have read many reports about second examinations revealing things that first examinations didn't.

Tell him to not be afraid of what might be found, as the earlier something is caught the better the possibility of a long, satisfying life thereafter.
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Re: Old Guy Medical Advice ?
Posted by: chopper
Date: December 06, 2019 05:49PM
What's crazy is that if he does not eat, he feels pretty good.

And that if he eats meals--anything-- after all day on the toilet or being close to one all day and feeling like crap THEN he can eat dinner and it's kind of normal for a few hours. In that he feels normal. No issues.

His Dr said maybe he has some kind of "good gut bacteria" issue.
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Re: Old Guy Medical Advice ?
Posted by: Ombligo
Date: December 06, 2019 06:09PM
Obviously he is not feeling good and nothing done so far has helped. Given that, then a second opinion from a gastroenterologist seems like a reasonable move. Putting things off just means being miserable for longer.



“No persons are more frequently wrong, than those who will not admit they are wrong.”
-- François de La Rochefoucauld

"WE CALL BS!" -- Emma Gonzalez
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Re: Old Guy Medical Advice ?
Posted by: S. Pupp
Date: December 06, 2019 06:32PM
He could try a trial of a lactose-free diet, or take Lactaid prior to dairy products if he cannot abstain from them. Sometimes, lactose intolerance can develop later in life.

If there is concern about a gut-bacteria issue, he could take probiotics to restore proper bacterial balance.

If he is eating containing sugar-alcohols such as sorbitol, xylitol, maltitol, etc (sometimes labelled as "no added sugar" or "sugar free"), that should stop at once. They can cause the symptoms he is describing, and are sometimes consumed by people with diabetes who are trying to reduce the amount of sugar in their diet.

Same goes for anything containing Orlistat, which is a non-absorbed fat (Pringles used to have a version with Orlistat, but I haven't seen it on any food products in some time).
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Re: Old Guy Medical Advice ?
Posted by: Filliam H. Muffman
Date: December 06, 2019 07:15PM
There is still a lot we don't know about the small intestine and how different strains of bacteria interact.

Does he get 30 minutes of exercise (equivalent of walking 2 miles) 5x a week?



In tha 360. MRF User Map
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Re: Old Guy Medical Advice ?
Posted by: Sarcany
Date: December 06, 2019 07:34PM
Wait... the "small town doctor" did the endoscopy and colonoscopy?? I'd expect that to be done by a GI guy.

Your friend NEEDS a GI consult.

There are feedback mechanisms between pancreas, gallbladder and liver related to diabetes that can cause lots of other issues seemingly unrelated to diabetes. All this stuff affects digestion.

But it's not just stuff related to the diabetes that could be causing these problems. He needs a specialist to nail this down... And if "small town doctor" did the endoscopy and colonoscopy, he'll probably need to get both done "right" by the specialist.

He might also talk to his GI specialist about blood tests for cancer/stress markers including (but not limited to) CA19-9, AFP, CA15-3, CA125, CA 27-29, and CEA. I'd expect a good GI guy to do at least three of those tests if he suspects cancer.

(...Even a bad GI guy would have done the CA19-9 along with a hepatic panel by now.)

...

Sorry. Made some substantive revisions after Diana quoted me. Didn't realize until I re-read the original message that his doctor wasn't a GI guy.







Edited 1 time(s). Last edit at 12/06/2019 07:41PM by Sarcany.
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Re: Old Guy Medical Advice ?
Posted by: Diana
Date: December 06, 2019 07:36PM
A second opinion is warranted, especially since he has had no relief from his primary care physician. I am not a medical doctor but I can say that there is much we do not know about the body and how it works, and with the rapid pace of new medical discoveries I doubt that the primary care physician is able to keep up with everything and still be able to see patients. This is one of the reasons doctors specialize. Between the stomach and the large intestine is a huge area that doesn’t lend itself well to direct observation so it would be a very good idea to find someone who does this kind of work, a gastroenterologist.

The ideas of lactose intolerance, sugars that have been promoted to aid the diabetic, good vs bad gut bacteria, etc are good ideas, but I’m somewhat sure the primary care physician would have checked the more obvious ones. You said that your friend underwent a course of antibiotics; this alone tells me that his regular doctor is pretty much on top of things as far as bad bacteria. Having said this, if the regular doctor has drawn a blank (so to speak) then it’s time to get to the specialist.

I had a longer reply, but the forum tossed its cookies over it. I don’t know what I said to get it upset, but it didn’t like it.

Diana
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Re: Old Guy Medical Advice ?
Posted by: Diana
Date: December 06, 2019 07:38PM
Quote
Sarcany
There are feedback mechanisms between pancreas, gallbladder and liver related to diabetes that can cause lots of other issues seemingly unrelated to diabetes. All this stuff affects digestion.

He should talk to his GI specialist about blood tests for cancer/stress markers including (but not limited to) CA19-9, AFP, CA15-3, CA125, CA 27-29, and CEA. I'd expect a good GI guy to do at least three of those tests if he's looking for cancer.

...Even a bad GI guy should have done the CA19-9 along with a hepatic panel by now.

Most GI guys will do a CA19-9 test at the drop of a hat, but that test is almost useless without other tests to correlate with because it can be elevated by stress or any number of secondary conditions affecting the liver. My impression is that using markers is still new enough that doctors who graduated from med school 20 years ago just don't have the reflex to go there. So, your friend may need to prod his doctor a bit to get a few marker tests done.

Seconded
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Re: Old Guy Medical Advice ?
Posted by: mattkime
Date: December 06, 2019 08:41PM
Obviously the full medical workup is important, but it might be IBS. I'd recommend a low FODMAP diet - [www.monashfodmap.com]

He should also keep a journal of what he's eating and how he's feeling. The most challenging part of working through food issues is that you'll swear you have it figured out until you don't. You have to admit you're wrong or something isn't accounted for otherwise you'll tie yourself up in knots diet wise.

Hope he figures it out and has many more healthy years ahead of him.

---

FWIW I'm casting a pretty suspicious eye toward the Dr Gundry's stuff.







Edited 1 time(s). Last edit at 12/06/2019 09:09PM by mattkime.
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Re: Old Guy Medical Advice ?
Posted by: testcase
Date: December 06, 2019 08:56PM
I've tried several of Dr Gundry's products. The "Vital Reds" powder has been the best of the lot. boink smiley
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Re: Old Guy Medical Advice ?
Posted by: S. Pupp
Date: December 06, 2019 10:18PM
Quote
mattkime
He should also keep a journal of what he's eating and how he's feeling. The most challenging part of working through food issues is that you'll swear you have it figured out until you don't. You have to admit you're wrong or something isn't accounted for otherwise you'll tie yourself up in knots diet wise.

Agreed.
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Re: Old Guy Medical Advice ?
Posted by: wave rider
Date: December 06, 2019 11:41PM
Second opinion sooner than later. Gluten sensitivity or other dietary allergies? Some hip replacement prosthesis were prone to leaching heavy metals into the system. Colitis?

Keep looking, be proactive, take friend or record doctor visits, keep fingers crossed. It took two years+ for the doctors to figure out what was going on with me…



=wr=
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Re: Old Guy Medical Advice ?
Posted by: rgG
Date: December 07, 2019 08:13AM
My mom had some digestive issues that sound rather like this, but maybe not exactly the same.
After a lot of tests and a colonoscopy, it was determined she had some sort of inflammation in her colon.
It has a name, but I don’t remember it.
Anyway, the treatment was to chew the chewable version of pepto bismol tablets up to eight a day to not only relieve the loose stools but it also coats the colon and actually helps treat the problem.
It has to be the chewable tablets, not the liquid or the ones you swallow. I am not sure exactly why it has to be the chewable ones, but it does.
He could try chewing a couple before meals to see if it helps.
I think my mom’s condition has gotten better, as she doesn’t mention the problem anymore.
Stress can bring on what she had, BTW.





Roswell, GA (Atlanta suburb)
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Re: Old Guy Medical Advice ?
Posted by: 3d
Date: December 07, 2019 09:17AM
Quote
chopper
What's crazy is that if he does not eat, he feels pretty good.

Check to see if there is a common link between all the meals. ie: Does he eat bread with every meal even though each meal is "different"? Soy is a common ingredient in many foods that can cause unwellness. A friend of mine was diagnosed with an allergy to some types of grain, soy and HOPS (beer) of all things.

Did your friend get an ocular allergy test?
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Re: Old Guy Medical Advice ?
Posted by: chopper
Date: December 07, 2019 12:37PM
Thanks much everybody. I have relayed all of this to him and he is going to get a second opinion next week, and make sure the guy is a GI expert.
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