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Elliot Ruff
Elliot Ruff,
Category: Medical
Satisfied Customers: 1748
Experience:  GP at Whitstable Medical Practice
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I have been suffering with bloating, bad bowel movements

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Hi. I have been suffering with bloating, bad bowel movements skin issues (hives, dry skin, red/orange spots on chest and stomach that disappear for a while with anti-fungul cream), 1 fungal toenail infection, reflux and joint pain for many years. GPs have said it would be IBS or allergies. My guess is a yeast overgrowth. I'm thinking about trying to get diagnosed and treated privately, however I don't have a lot in saving and have a low income. Any advice would be great, eg. What the tests would be? how much would this cost?
JA: The Expert's answer will cost $10 to $100, depending on the issue type and time to respond. You'll see the exact amount on the next page and can decide then. It's way less expensive and more convenient than any face-to-face visit.
Customer: Ah okay, when the domain said UK I assumed it would be a UK site
JA: How long have you been dealing with this? Do you notice any redness or scaling?
Customer: Different symptoms started at different times but the majority of symptoms have been about for about 4/5 years with the earliest one I can remember 7 years ago scaling as in dry skin?
JA: Anything else in your medical history you think the Doctor should know?
Customer: I have had excema and a white coating on my tongue since childhood. The excema comes and goes. About 4 years ago I developed hayfever, however I have had very watery eyes since childhood. I'm allergic to codiene (if that's how you spell it). My dad has high blood pressure. My brother has Crohn's disease and my grandfather died at 65 due to I believe stomach cancer or at least somewhere in his digestive tract. I can't think of anything else off the top of my head you should know.

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?

Customer: replied 2 day ago.
I've had a stool test done by my GP, nothing ever came of it, and an organic acids test (organic acids test was done to try and self diagnose meaning it wasn't recommended by a health professional).
In regards ***** ***** single toenail comment. Could you explain the possible cause of the spots on my stomach and chest. I've had that 3 times. The 3rd time covering all of my chest and half of my stomach. Would that be a systemic problem?
Customer: replied 2 day ago.
I've also had several blood tests done to check for allergies and signs of inflammation
Customer: replied 2 day ago.
Also didn't hear back from these

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.

Customer: replied 1 day ago.
The GP said that they would call if the blood tests showed in problems. Nobody called so I assume that means there are no signs of inflammation. The spots have cleared up a lot after using the antifungal cream again but you can make some of them out
Customer: replied 1 day ago.
any problems

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.

Customer: replied 1 day ago.
I do shave my stomach. But it is usually worse on my chest which I don't shave.
I hate asking for referrals. The GP is always very skeptical and they take ages to get an appointment. Does it matter how prevalent the condition is when a biopsy is performed?

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.

Customer: replied 1 day ago.
To be honest the fungal rash doesn't bother me as much as the bloating and reflux. I gain weight easily but my stomach is less irritable when I eat processed foods so I usually have a choice of discomfort or weight gain.

Have you ever taking any medication for the bloating or reflux?

Customer: replied 1 day ago.
Would that mean I would have to let the rash come back then ask for a referral and then keep the rash until the biopsy which could be many months down the line.
Customer: replied 1 day ago.
I was prescribed something for IBS but it didn't have any effect and I was told nothing else could be done.

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.

Customer: replied 1 day ago.
I've tried, Fodmap, paleo, keto, whole food plant based, body ecology, elimination and even fruitarian diets. None of them less than 2 months. A small amount of change with each but nothing substantial. Best results on WFPB. Worst was probably Keto or Fodmap.
What is PPI?

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.

Customer: replied 1 day ago.
The contents of my bowel usually contain large food particles even though I chew thoroughly. If I reduce the acid content of my stomach would that make it worse?
Customer: replied 1 day ago.
Can you just ask for a colonoscopy?

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.

Customer: replied 1 day ago.
As you can probably tell I have a pessimistic view of the GP side of the NHS.
I asked to see a gastroenterologist before but the GPs attitude and skepticism swayed my decision to seek help.
I will be stronger willed in my decision this time.
Anyway thanks for the help

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.

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