here's a challenge for all you medically minded folk...
i have an acquaintance, let's call him minky, who for some time now
has experienced the recurrence of a certain annoyance.
allow me to explain: minky, a caucasian male in his mid-twenties and
in no significant risk groups, has a bit of problem related, as best
we can tell, to his mouth and something in his stomach. i'll give you
the gist of the problem first, then significant details, and then the
things we've done in the past to try and figure out what is going on.
the question in all of this is simple: has anyone seen anything like
this before? can someone out there help poor minky? the doctors he's
spoken with don't seem to be particularly familiar with his type of
situation.
here's the situation, in it's present manifestation. generally
speaking, minky's a healthy and normal individual, but if you put him
in a situation where he has to *seriously* exercise for a decent
amount of time (say 25-30 minutes or more, much of it anaerobic), and
he's recently had a meal, he's likely to have a problem. in these
types of situations, minky describes 'burping up' bits of his food
and/or stomach acid.
no big deal, you might say, as most of us may have experienced that
sort of thing before. i certainly have. but that's just the beginning.
the next morning minky will wake up with what he says feel like
sun-burnt lips. irritation from the stomach acid? maybe, but the
problem doesn't stop there. over the next few days the burning turns
into a sort of mogul field of teeny tiny blisters or bumps, which get
slightly larger over time (you have to look very closely to see them),
tend to get 'harder' and feel rough to his tongue, and have a bit of a
white covering on them when he wakes up in the morning which can be
wiped/washed off. at that point minky says his lips are very painful
(orange juice in the morning is a real wake-you-up).
what happens after that? minky isn't sure, because he knows the cure
for what ails him, at least in the short term. a few days with a
topical dental metronidazole gel and his lips are as good as new, or
well on their way to being so. assuming he can keep his exercise
routine in check, he's fine.
ok, so that's the end of the basic story, but there are more details
which help fill in some gaps. why the metronidazole gel? it was
prescribed to him the first time he experienced the 'lip problem'
about 18 months ago, while on a 10-day trip to india. while in india
he experienced the same (lip) symptom progression, minus the exercise
and the burping, and the house doctor at a fancy hotel gave him a
short supply of oral antibiotics and the gel. within a few days he was
'cured'. the doctor said he had infected his lips with a bacteria or
fungus from food that wasn’t clean or possibly from touching his lips
with a dirty hand. he hasn’t since returned to india or anywhere
similar.
minky also returned from india with giardia (a stool sample tested
positive), and was prescribed metronidazole tablets (standard
treatment for giardia) several weeks after he got back to the states.
as is commonly the case with parasites, his stomach didn't seem to
'fully recover' for a while, and for some time he experienced lots of
gas and burping after meals. a second round of metronidazole was
prescribed 'just to be sure', and later a full parasite test (stool)
registered negative across the board. during this time, the 'lip
problem' was re-appearing as well, and while it was considered, it
wasn't clear that the stomach and lips issues were related.
minky's stomach has more-or-less returned to normal (unless you run
him like a quarter horse), and for a while he thought the 'lip
problem' had ceased as well. after no problems in either area for
months, only this week the 'lip problem' resurfaced after an
over-strenuous workout and a resultant upset ('food and acid burps’)
stomach. while the correlation had been considered in the past, now it
seems almost undeniable that his lip ‘infections’ follow bouts
with acid burps.
so what on earth is going on? that's the $60 question. while comments
are welcome, please DO NOT 'answer' with the following (unless they're
part of a larger, comprehensive explanation):
* what metronidazole is used to treat, what it contains, etc.
* that minky should have an upper and/or lower endoscopy. that's the
plan if there's no winner here :)
* that minky should have blood work done (he has) or have his blisters
swabbed and sampled (he has). a closer look or better sample may, like
an endoscopy, prove more promising, but that's not really an answer
either.
* that minky is probably suffering from candida, candidiasis, leaky
gut, IBS, yeast overgrowth, or a foreign flora which took over his
stomach during or after the anti-giardia treatments. these options
have been considered and explored. while the problem may lie in this
area, these diagnoses are not specific enough to be helpful in any
particular way (he's tried the candida diets and herbal 'remedies').
the problem with the generic candida-type diagnoses is that they're a
catch-all for everything from stomach aches to hair shedding, and not
particularly helpful on their own. a specific cited example of yeast,
etc. being 'burped up' and leading to an infection on the lips,
along with how it was cured, however, ...
basically, what we're hoping for is that someone out there recognizes
this in a way that minky's doctors so far haven't been able to, and
knows right away what is going on because they've seen just this sort
of thing before. i've done lots of web research for minky and haven't
found much, so if you have no idea you may want to pass...but maybe
someone out there has seen or experienced just this sort of thing in
the past...
clarification questions are welcome and every effort will be made to
respond/clarify.
thanks,
gentryunderwood-ga |
Request for Question Clarification by
aceresearcher-ga
on
06 Nov 2002 01:35 PST
gentryunderwood,
It is quite possible that "minky" is experiencing the effects of more
than one disorder, illness, or disease.
One thing minky should probably do straight off is stop exercising
immediately after eating a meal. The body has a "fight or flight"
response that short-circuits what it considers non-essential functions
while the body is under attack. In this case, the perceived attack is
the exercise, and the non-essential function is digestion. As long as
minky is exercising, all that food is going to sit in his stomach,
undigested. This increases the possibility that minky is going to
experience gastro-esophageal reflux. While the reflux may be part of
some larger disease process, one of the best things minky can do right
now is eliminate the exercise immediately after eating.
Now for the rest of the symptoms: While I sympathize with minky's
plight, and I think Google Answers is a pretty neat service, it is NOT
the place to go for a diagnosis. I am sure that minky is very
frustrated, if he has gone to several doctors and had several tests
done, and no one has been able to identify and cure the cause of the
symptoms. However, painful and frustrating as it may be, minky needs
to KEEP going to doctors until he finds one who is able to identify
and treat whatever is causing these symptoms.
Just because bloodwork and tissue samples may have been done, it does
not mean that the right tests were done on the blood and tissue, or
that the right person looked at the blood and tissue. The endoscopy,
while not particularly pleasant, is probably another important step in
discovering the source(s) of minky's problems.
I can offer one suggestion to minky: there is at least one disease
that is chiefly seen and recognized most often by dermatologists
(because it usually manifests primarily in the skin) which can cause
symptoms similar to some of those that minky is experiencing. So one
thing minky can try is a visit to a dermatologist, who might be more
likely to explore different possibilities than a general practitioner
or other kinds of specialists.
Please, please persuade minky to pursue diagnosis by real physicians.
If, by some chance, minky has something very serious, any delay in
diagnosis and treatment could make a real difference in minky's
long-term prospects.
I hope most sincerely that minky will find a diagnosis and resolution
to the symptoms he is experiencing. Please wish him luck from me.
Regards,
aceresearcher
|
