What could be the reason for severe nausea, heartburn, stomach pain, and vomiting?

Question

Hello doctor,

I had visited my primary care physician twice and had emergency medical treatment in the last six weeks due to severe nausea, heartburn, stomach pain, and vomiting. I have also been treated for persistent thrush with 21 days of Diflucan. My normal test results were normal, and the CT scan without contrast was negative. Is there any possibility that I have H. Pylori and Candida infection?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed your case history and attached laboratory investigations in detail (attachments removed to protect the patient's identity).

The thrush should have responded very well to Diflucan (Fluconazole) tablets, and you have candidiasis. It presents as white coated tongue or patches. If you are on oral antifungal, your treating physician must have considered it esophageal candidiasis as well, as you took 21 days of Diflucan. In that, one should evaluate why you have such extensive candidiasis. Risk factors include poorly controlled diabetes mellitus, use of immunosuppressive therapy, or significantly compromised immunity for any reason. For Helicobacter pylori, you can have an H. pylori stool antigen or urea breath test. You will need two weeks of antibiotics with good acid suppression medicine if it comes positive.

Regarding your symptoms, you are already on proton pump inhibitors (acid suppression medicine). However, if you are still symptomatic, you may need further evaluation with the help of an endoscopy to diagnose precisely the cause behind your symptoms. Meanwhile, continue your medicine, take small frequent meals, take your last meal two to three hours before going to bed, and avoid the use of NSAIDs (non-steroidal anti-inflammatory drugs) group of painkillers.

Thank you.