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Gastroenterologist appt tmrw, suggestions needed

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jess
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Gastroenterologist appt tmrw, suggestions needed

Post by jess »

I have an appt with my gastroenterologist tomorrow. I saw him in 2009, was tested for h-pylori which was negative, and had en EGD wich showed no abnormalities. So I'm gonna see him again tommorrow and will ask him to test me for h-pylory again and also ask him about small intestinal bacterial overgrowth. Any suggestions on what else I should ask him this time?


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deebo
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Post by deebo »

thanks for reposting the FB Jess
you might ask what his knowledge and experience is with chronic malodor issues . Has he heard of TMAU ? One of the things i wanna check with a gastro or ENT is diverticula pockets anywhere from the throat down. I'd want to be up front that all past tests have been "normal" but that an offensive odor persists (if thats your experience) .I'd want to know what he'd do differently than the norm to find a cause or I'd be tempted to walk out . If I knew I had odor that day ,I'd ask "what" he smells , and not "if" he could smell me . just my 2 cents
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jess
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Post by jess »

Great advise. Thank you Deebo.
noway
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Re: Gastroenterologist appt tmrw, suggestions needed

Post by noway »

jess wrote:I have an appt with my gastroenterologist tomorrow. I saw him in 2009, was tested for h-pylori which was negative, and had en EGD wich showed no abnormalities. So I'm gonna see him again tommorrow and will ask him to test me for h-pylory again and also ask him about small intestinal bacterial overgrowth. Any suggestions on what else I should ask him this time?
If you can control belching, So, leave H-pylori alone and save your money, I know more than 3 ppl already suffers from H-pylori with its maximum painful symptoms and they have no BB! oral BB = Oral cavity source, my advice duodenal, intestinal and colon endoscopy (the place of connection between blood and GI lining tissue) will help you more to detect if you have GI inflammatory disease like Ulcerative Colitis.. that will lead you for the right way... Good Luck!
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Post by rikki »

Jess, how was your appointment? Did they test you for SIBO?
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jess
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Post by jess »

Just got back from my appt with the gastroenterologist. I reminded him that I saw him in 2009 and that I've been suffering with bad breath for 13 years now. He said that he remembered me and that the EGD I had then showed everything was "perfect" (that's the word he used). I told him that there's not a day that goes by without me not having bb despite of the fact that everything I've tested for came back normal. He asked me how I knew I have bb and I told him that I cannot smell my own breath but family members and people at work have mentioned that I do have it.

He then came to my face, positioned his nose right in front of my mouth and told me to breathe. I did and he said that he couldn't smell anything bad at all. He did that a few times and insisted that he didn't smell anything and that my breath was neutral. I told him I do have chronic bad breath and he then proceeded to tell me about a mint called "mentos" which I can find at any pharmacy and that has an ingredient in it called xylitol. I didn't want to cut him off so I waited until he was done talking and told him that I know all about xylitol and that in fact the only gum I've been using for the past few years is sweetened with 100% xylitol. He then said that was a good thing and that I should keep using it because over time the xylitol is capable of reducing the bacterial load in the mouth and thus reducing bad breath.

I then told him that I'd made a list of things I wanted to ask him about; he said that was fine and so I startedd asking him about diverticula pockets, SIBO, TMAU, etc. He reminded me that there were no pockets whatsoever when he did the EGD. He said SIBO normally caused gas and bloading, but usually not bad breath. He said that he never heard of TMAU and had no idea what it was but said that he would look more into it.

I asked him if it was ok to get tested for h-pylori again; he said yes and told me he would do it right in his office. I then mentioned that I was currently on antibiotics (for something unrelated to this) and that today was my last day on it, and that's when he said that he would not test me for anything today and that he would see me back in his office in ten days after the effects of the antibiotic wore off. I then mentioned to him that's probably why my breath's not too bad today and he agreed. I told him I had more questions but he said he wouldn't charged me for today's visit and that we would just talk about everything else in my next appt which is in ten days.

So overall I'm pretty happy with how everything went. Eventhough he said he couldn't smell my breath he didn't dismiss me telling him that I suffer from it, and he didn't say or suggest that it was all in my head. And I think the reason why he couldn't smell my breath today is because I'm on the antibiotics. And I also like the fact that he didn't charge me for today's visit.

So I have an ppt and will see him again April 2nd. If you guys have anymore suggestions on what to ask him, please share them here.

BTW: From your suggestions here and the FB group, I already have these following things to discuss with him: food allergies, IBS, chrohn's disease, celiac disease, parasites, liver congestion/issues.

Thanks for reading
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Post by jess »

Just realized this is a very long post, lol.

So basically I saw my gastroenterologist today, but he couldn't do any tests because I'm on antibiotics, so I will go back to see him in ten days when the effects of the antibiotics wear off.
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Post by emotional rescue »

Great!

I´m kind in the same situation, I will ask about the same things in my next appointment.

Good luck
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Post by jess »

GI APOINTMENT UPDATE
So to folow up on the post above, I went back to the GI doctor yesterday because as mentioned above he wanted to see me in ten days when the effects of the antibiotics I was on wore off. So I saw him and he did the pylori test again, and again I tested negative for it.

I had a list of all the things to ask him about (allergies, ibs, sibo, tmau, celiac, chrohn's disease, parasites, liver problems) and here's what he said:

Celiac disease, parasites, IBS, chrohn's disease: not likely, because he said I would've had other symptoms, not just bb, if I had those.

Allergies: he reffered me to another doctor (he said his lab partner) to get tested for those, and therefore I will see that other doctor in about a week or so.

TMAU: he's not that familiar with it and said he's gonna find out whether or not it's something I can get tested for in my area, or if it's something he's gonna have to order from another place.

Please read this because to me this is the most interesting part:
SIBO: he said there's no real way of testing for it, but he said he's gonna put me on some antibiotic for it. I immediately told him that I've been on antibiotics before and that they didn't really help because every time I come off of them the odor came back. Then he said this particular antibiotic is designated to treat gut bacteria only and that the bacteria can not build resistance against it. So I became interested and accept to take them.

So the name of the antibiottic is Xifaxan (rifaximin). He gave me a week supply of it and said if I feel that it makes any positive difference at all to call him and he would put me on it for a month or so.


Therefore that's what I'm gonna do. So please share your thoughts on this. Is any of you familiar with this antibiotic? Have you tried it before? Did it work, did it not work? Please reply
rikki
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Post by rikki »

Jess, Rifaximin is the drug used to treat SIBO (also travelers diarrhea) and diandra just posted a couple of weeks ago that this is what actually cured her. Please keep us updated on how this antibiotic works for you. It is unfortunately not available in Canada where I live but I believe it could help the people who actually have SIBO. Also, for how many days are you taking it?
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Post by ma51fyfy »

@jess

what dose are you taking. I also took it last week.

3x200mg for 4 days. It did nit help at all.

Do you think the dose was too small?
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Post by noway »

jess wrote:
Please read this because to me this is the most interesting part:
SIBO: he said there's no real way of testing for it, but he said he's gonna put me on some antibiotic for it. I immediately told him that I've been on antibiotics before and that they didn't really help because every time I come off of them the odor came back. Then he said this particular antibiotic is designated to treat gut bacteria only and that the bacteria can not build resistance against it. So I became interested and accept to take them.

So the name of the antibiottic is Xifaxan (rifaximin). He gave me a week supply of it and said if I feel that it makes any positive difference at all to call him and he would put me on it for a month or so.
Yes, it is very interesting, and great step!
My expirecne on like this type of drugs was anti fungi called Daktarine (oral gel) , fungi don't develop a resistance to it and it was not absorb-able and gave me 75% cure but the problem was i have tolerated to it after one month of regular using and my body reacted to it through lymph nodes (tonsils and pharyngeal ...) to produce odor which 1000% worst.

If Xifaxan is a topical anaerobic antibiotic and not absorb-able that means it will targets a certain parts of your body and this will help you a lot to discover the source of BB (from your H-Pylori and gut bacteria or from throat) but you should ask your doctor if it affects anaerobic germs or not to judge the results well..

finally, I prefer if you give some attention for cortisone level tests in your diagnosis trip because it's the master hormone which controlling your immune system and its source is the adrenal gland (a small triangle endocrine gland over the kidney responsible for secrete stress hormones and one of them is cortisone), please include this in your concern...

Good luck...
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Post by emotional rescue »

Good luck jess,

I will ask about it in my next appointment, next week
Stankie

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Last edited by Stankie on Sat Aug 17, 2013 7:05 pm, edited 1 time in total.
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jess
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Post by jess »

Thank you all for your replies.

Here's another update:
As mentioned above, my doctor gave me a 6 day-supply of the rifaximin 550mg 2 times a day. Three days into taking the med, I felt there was a slight difference in my breath (which was not a big deal to me because antibiotics always do that when I first start taking them). So I called his office and mentioned that and the doctor ended up ordering a month supply for me. I pick it up at the pharmacy three days ago and I've been continuing taking it since.

I will keep taking it until I finish the 30-day supply and I'll keep you guys posted. As of right now there's no major difference in my breath as of yet. I've been reading Diandra posts regarding this ABX and I'm hoping it is the cure for me as well, but so far there's nothing to get too excited about yet. But I'm still hoping for the best.

As a side note, I read somewhere that some health insurance don't cover this drug and I was a bit concerned that mine wouldn't cover it either; but as soon as my doctor called the prescription in to the pharmacy there were no problem. I only paid a $25 copay.
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