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Good evening, I am Dr Ruff, thank you for contacting us this evening.
I am sorry that you have been suffering with these symptoms. I would suggest quite early on that I think you would be wasting your money trying to look into a yeast overgrowth causing these symptoms. I would suggest that your symptoms are coincidental rather than connected.
I would encourage you investigate these symptoms individually, such as Bloating/Bowel movements as one issue, the joint pain as a second issue.
If you had a systemic fungal infection you would be getting systemic fungal symptoms, so not one toenail being affected.
I can understand the link you have made, but would suggest you will spend a lot of money privately to find an answer.
What investigations have you had so far for your bowels?
Okay thanks. So if you have had change in bowel habit, IBS is a diagnosis of exclusion. You should have blood tests to check for inflammatory markers to suggest inflammatory bowel disease, look for ferritin or anaemia or raised platelets suggesting something more sinister.
A stool sample will just tell you if you have any infection or not.
Do you have a photo of these spots please?
You should chase these results and that someone has seem them.
Thanks. This is subtle but you can see some inflammation, so I would agreed this has a fungal appearance.
If you do not mind me commenting, do you shave the hair in this area? It is worth noting that shaving can be a cause if this is recurrent.
However if this is recurrent and not responding to treatment, you should ask for a referral to dermatology, where if any doubt as per the diagnosis, they can do a biopsy for a tissue diagnosis to direct the treatment of this.
I understand, but if a problem persists then it is not unreasonable to ask to be referred. And yes, you need to biopsy and inflamed area, if the skin is normal in appearance it is unlikely to provide a diagnosis.
You certainly wouldn't need to pay privately by doing this.
Have you ever taking any medication for the bloating or reflux?
No, I would ask for a referral on the basis of recurrence, just take photos. Otherwise the timing of an appointment will be very challenging.
So if you do have IBS, following a type of diet called FODMAP is the mainstay treatment, symptomatic management is not as useful as the medication can cause side effects. IBS however does not cause acid reflux symptoms, therefore PPI medication such as Omeprazole would help with this.
Okay thanks, ***** ***** improvement with FODMAP, I would question the diagnosis, not to say it is not IBS, but it should improve.
A PPI, Omeprazole, Lansoprazole, Esomeprazole reduce the acid content of the stomach and therefore reduces reflux symptoms.
I would consider getting a colonoscopy to investigate your symptoms further.
I do not think it will, but diarrhoea is a possible side effect of the drug, you will still undergo digestion.
It depends on your local trust, normally not, but I would be asking to see a Gastroenterologist first anyway.
I understand your concerns, but if you do not go back, they will have no concept of how much this is effecting you.
Best of luck, I hope you find a way to mange this soon.