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Can Lubiprostone Be Used In An Advanced ALS Patient Having Trouble Breathing Because Of Diaphragmatic Involvement?
Question: My ALS patients have a chronic dysbiosis with an overgrowth of yeast (Candida) and invasion into their intestinal wall(s) and blood, stool and urine tests that indicate they have mounted an immune response with elevated antibodies and often have tests such as labcorp's expanded bowel panel that are positive for severe Crohn's. They do not respond well to the common antifungals even though I rotate them and use them at high doses. They lose weight and have evidence of chronic subclinical endotoxemia with endotoxins in their blood. There is a drug lubiprostone that did show effectiveness in improving the intestinal permeability. Do you think this can be used in an advanced ALS patient who is having trouble breathing because of diaphragmatic involvement?
Any other thought on other more safe remedies to stop the endotoxin poisoning, etc
Any other thought on other more safe remedies to stop the endotoxin poisoning, etc
Brief Answer:
Please go through explanation.
Detailed Answer:
Hello,
Firstly i am sorry for the patient.
Secondly if you think patient is relieved by Lubiprostone you can continue to give it.Its a very safe drug and normally is very well tolerated by patients.Only usual contraindication of this drug is that its not given in patients having chronic diarrhea.Any effect on respiration is not mentioned in any standard texts.So from our side you can give this drug to patient.
See firstly candida or any other fungus is very difficult to treat in a patient having other morbid conditions. as per the history given by you the fungus had invaded into gut wall,blood stream etc.This could lead to development of condition called sepsis where a number of toxins are produced in blood stream leading to failure of organs one after other.
I would like to go through the complete paper work(all reports investigation summaries etc) before giving any suggestion of adding medicines.
However as far as fungus is concerned consider adding fluconazole 200mg intravenous therapy(consult a MD for the same).Parentral therapy has much better effect on fungus as compared to oral medications(specially in high risk patients).
Attach all documents with follow up.
Would be happy to help you.
Thanks and regards!
Please go through explanation.
Detailed Answer:
Hello,
Firstly i am sorry for the patient.
Secondly if you think patient is relieved by Lubiprostone you can continue to give it.Its a very safe drug and normally is very well tolerated by patients.Only usual contraindication of this drug is that its not given in patients having chronic diarrhea.Any effect on respiration is not mentioned in any standard texts.So from our side you can give this drug to patient.
See firstly candida or any other fungus is very difficult to treat in a patient having other morbid conditions. as per the history given by you the fungus had invaded into gut wall,blood stream etc.This could lead to development of condition called sepsis where a number of toxins are produced in blood stream leading to failure of organs one after other.
I would like to go through the complete paper work(all reports investigation summaries etc) before giving any suggestion of adding medicines.
However as far as fungus is concerned consider adding fluconazole 200mg intravenous therapy(consult a MD for the same).Parentral therapy has much better effect on fungus as compared to oral medications(specially in high risk patients).
Attach all documents with follow up.
Would be happy to help you.
Thanks and regards!
Above answer was peer-reviewed by :
Dr. Kampana
vERY HELPFUL. iF IV FLUCONAZOLE DOES NOT WORK WHICH OTHER IV ANTI-FUNGAL SHOULD i USE? iS THERE ANYTHING BETTER THAN NYSTATIN FOR THE INSIDE OF THE gi TRACT?
Brief Answer:
Follow up.
Detailed Answer:
Hello again dear,
when used intravenous fluconazole has best effect.
Doses can be given upto 200 mg twice daily for minimum of 14 days.
In some cases amphotericin B can be given in combination of fluconazole.
They are much better then Nystanin.
Hope i was helpful.
Follow ups are welcome.
Suggestion to make answer better is welcome.
Regards and do rate answer.
Follow up.
Detailed Answer:
Hello again dear,
when used intravenous fluconazole has best effect.
Doses can be given upto 200 mg twice daily for minimum of 14 days.
In some cases amphotericin B can be given in combination of fluconazole.
They are much better then Nystanin.
Hope i was helpful.
Follow ups are welcome.
Suggestion to make answer better is welcome.
Regards and do rate answer.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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