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Hello Doctor, I Am A Patient With A Suspected Abdominal
Posted on
Tue, 5 Mar 2019
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Tue, 5 Mar 2019
Answered on
Last reviewed on
Question : Hello Doctor,
I am a patient with a suspected abdominal issue, that both my primary care doctor and gastroenterologist wish to further investigate.
An MRI (Enterography) was recently ordered.
Due to my own personal reasons as well as due to complex health reasons, I have chosen to decline both the use of gadolinium IV contrast, as well as the use of Mannitol and sorbitol-based oral hydrosolution (which is provided in order to cause the intestines to distend, for optimal imaging). Under no circumstances will I agree to be administered these agents.
Given this limitation, the patient, the primary doctor, the gastroenterologist, and any potential radiologist associated with the MRI, all have a choice to make. They can EITHER:
(1) encourage the MRI to proceed as a total non-contrast MRI, with no distention of the gastrointestinal tract; or,
(2) encourage the patient to consume at least some other fluid, in order to encourage maximal distention of the intestines as possible.
One of these two options makes sense medically, but the other does not.
I pose that every radiologist, when faced with this dilemma, may instinctively realize that proceeding without distending the bowels would be a detriment and a barrier to obtaining the most optimal scan possible, which is what is in the best interest of both the radiologist, and the patient, as well as all his doctors. We look to reduce the risks of lowered test sensitivity and false negatives.
…
Pursuant to this, I have had a talk with my primary care doctor. We discussed the options, and eventually, a statement signed by him was produced, instructing and encouraging both the patient and the MRI center to have the patient (myself) take juice as an oral contrast, in order to promote distention.
From his letter:
“I have discussed the pros and cons of declining contrast media with my patient. I have informed him that, despite declining a gadolinium-based contrast, that it is in our best interests to do everything we can in order to raise the image quality of the MRI scan to be produced.
“Pursuant to this, I have recommended that my patient agree to take alternative forms of contrast that will enhance the image quality, compared to a non-contrast MRI.
“For oral contrast:
‘As per studies reported, such as Effectiveness of natural oral contrast agents in magnetic resonance imaging of the bowel (2015), pineapple juice, compared to water, provides superior distention of the small bowel, which is one of our primary goals. Image artifacts are reduced as well, and image quality is significantly enhanced.
‘Moreover, as a result of the high manganese content of pineapple juice, there is evidence to show that higher concentrations of manganese compound in both the intestines and in systemic absorption/circulation, may produce slightly enhanced image quality; as per studies investigating novel use of manganese compounds positioned to eventually replace gadolinium- based compounds for MRIs, we find that ‘[the manganese element] has an ability to produce an MR signal comparable to that of GBCA’s …'
“I recommend for my patient to use pineapple juice as oral contrast if declining other forms, which has been approved and procured for the patient to bring.”
Further notes, from the source study itself, on the matter of using pineapple juice as an effective oral contrast:
“To guarantee adequate small bowel distention, the rapid physiological absorption of water needs to be delayed by using some additives to prevent or delay its absorption like Mannitol or sorbitol, but they may lead to many unwanted effects such as diarrhea, vomiting and nausea especially with mannitol. In our study, we are adherent to the aim of this work by using absolute natural contrast agents, so we did not use any additives to enhance water function.
Based on our results, Pineapple is an ideal solution that can be used as an oral contrast agent in MRI enterography. It is natural, does not need addition of chemical agents to reduce its absorption – like in cases of water-, and has good ability for bowel distention, good image quality, with no image artifacts in addition to its good taste and very minimal abdominal discomfort. “
Presentation of this letter is made to the MRI center.
…
Now, imagine that you are the radiologist. You see that the test ordered, by a gastroenterologist, is specifically to investigate a gastrointestinal issue (vis-a-vis Enterography). It has been indicated to you that the patient exercises his right to decline the specific agents of gadolinium and Mannitol/sorbitol solution and will under no condition accept those; at the same time, you also understand that the most paramount objective is to produce the most high-quality scan that is technically possible, within the circumscribed limitations posed by the patient. You are aware of the information presented on using juice such as pineapple juice (which shows most clearly on MRI scans due to high manganese content), and you are shown a letter from the patient’s main doctor supporting and encouraging its use. Finally, you are told that the patient is willing to drink this pineapple juice in order to drastically improve the scan quality.
A quick Google search online by you reveals more published studies of pineapple juice for use as oral contrast; additionally, you also find a multitude of anecdotal stories where radiologists and MRI technicians who know about pineapple juice being an excellent alternative are using it on patients who don’t want to accept the regular stuff, and they are doing so without any apparent issue.
Ultimately, you find that there is no medical reason or contraindication against its use; this is weighed against a host of beneficial effects by including its use, as it may serve a legitimate purpose by contributing value to the scan quality and results, where the alternative would be no oral fluids admitted at all, producing diagnostic results of an inferior yield.
QUESTIONS
(1) Do you allow the patient to use juice to distend the intestines for the scan? Ion practical terms, is it the best option available, given the restrictions?
(2) What would the alternatives be—and are they preferable or even acceptable?
(3) Does it make sense, from a purely practical standpoint, to discourage the proposed course of action outlined by the doctor?
(4) Given that the scan is for a potentially emergent issue, which are plausibly liable to reveal significant pathologies, does it make sense to discourage or delay rendering of the MRI scan altogether?
Thank you so much.
I am a patient with a suspected abdominal issue, that both my primary care doctor and gastroenterologist wish to further investigate.
An MRI (Enterography) was recently ordered.
Due to my own personal reasons as well as due to complex health reasons, I have chosen to decline both the use of gadolinium IV contrast, as well as the use of Mannitol and sorbitol-based oral hydrosolution (which is provided in order to cause the intestines to distend, for optimal imaging). Under no circumstances will I agree to be administered these agents.
Given this limitation, the patient, the primary doctor, the gastroenterologist, and any potential radiologist associated with the MRI, all have a choice to make. They can EITHER:
(1) encourage the MRI to proceed as a total non-contrast MRI, with no distention of the gastrointestinal tract; or,
(2) encourage the patient to consume at least some other fluid, in order to encourage maximal distention of the intestines as possible.
One of these two options makes sense medically, but the other does not.
I pose that every radiologist, when faced with this dilemma, may instinctively realize that proceeding without distending the bowels would be a detriment and a barrier to obtaining the most optimal scan possible, which is what is in the best interest of both the radiologist, and the patient, as well as all his doctors. We look to reduce the risks of lowered test sensitivity and false negatives.
…
Pursuant to this, I have had a talk with my primary care doctor. We discussed the options, and eventually, a statement signed by him was produced, instructing and encouraging both the patient and the MRI center to have the patient (myself) take juice as an oral contrast, in order to promote distention.
From his letter:
“I have discussed the pros and cons of declining contrast media with my patient. I have informed him that, despite declining a gadolinium-based contrast, that it is in our best interests to do everything we can in order to raise the image quality of the MRI scan to be produced.
“Pursuant to this, I have recommended that my patient agree to take alternative forms of contrast that will enhance the image quality, compared to a non-contrast MRI.
“For oral contrast:
‘As per studies reported, such as Effectiveness of natural oral contrast agents in magnetic resonance imaging of the bowel (2015), pineapple juice, compared to water, provides superior distention of the small bowel, which is one of our primary goals. Image artifacts are reduced as well, and image quality is significantly enhanced.
‘Moreover, as a result of the high manganese content of pineapple juice, there is evidence to show that higher concentrations of manganese compound in both the intestines and in systemic absorption/circulation, may produce slightly enhanced image quality; as per studies investigating novel use of manganese compounds positioned to eventually replace gadolinium- based compounds for MRIs, we find that ‘[the manganese element] has an ability to produce an MR signal comparable to that of GBCA’s …'
“I recommend for my patient to use pineapple juice as oral contrast if declining other forms, which has been approved and procured for the patient to bring.”
Further notes, from the source study itself, on the matter of using pineapple juice as an effective oral contrast:
“To guarantee adequate small bowel distention, the rapid physiological absorption of water needs to be delayed by using some additives to prevent or delay its absorption like Mannitol or sorbitol, but they may lead to many unwanted effects such as diarrhea, vomiting and nausea especially with mannitol. In our study, we are adherent to the aim of this work by using absolute natural contrast agents, so we did not use any additives to enhance water function.
Based on our results, Pineapple is an ideal solution that can be used as an oral contrast agent in MRI enterography. It is natural, does not need addition of chemical agents to reduce its absorption – like in cases of water-, and has good ability for bowel distention, good image quality, with no image artifacts in addition to its good taste and very minimal abdominal discomfort. “
Presentation of this letter is made to the MRI center.
…
Now, imagine that you are the radiologist. You see that the test ordered, by a gastroenterologist, is specifically to investigate a gastrointestinal issue (vis-a-vis Enterography). It has been indicated to you that the patient exercises his right to decline the specific agents of gadolinium and Mannitol/sorbitol solution and will under no condition accept those; at the same time, you also understand that the most paramount objective is to produce the most high-quality scan that is technically possible, within the circumscribed limitations posed by the patient. You are aware of the information presented on using juice such as pineapple juice (which shows most clearly on MRI scans due to high manganese content), and you are shown a letter from the patient’s main doctor supporting and encouraging its use. Finally, you are told that the patient is willing to drink this pineapple juice in order to drastically improve the scan quality.
A quick Google search online by you reveals more published studies of pineapple juice for use as oral contrast; additionally, you also find a multitude of anecdotal stories where radiologists and MRI technicians who know about pineapple juice being an excellent alternative are using it on patients who don’t want to accept the regular stuff, and they are doing so without any apparent issue.
Ultimately, you find that there is no medical reason or contraindication against its use; this is weighed against a host of beneficial effects by including its use, as it may serve a legitimate purpose by contributing value to the scan quality and results, where the alternative would be no oral fluids admitted at all, producing diagnostic results of an inferior yield.
QUESTIONS
(1) Do you allow the patient to use juice to distend the intestines for the scan? Ion practical terms, is it the best option available, given the restrictions?
(2) What would the alternatives be—and are they preferable or even acceptable?
(3) Does it make sense, from a purely practical standpoint, to discourage the proposed course of action outlined by the doctor?
(4) Given that the scan is for a potentially emergent issue, which are plausibly liable to reveal significant pathologies, does it make sense to discourage or delay rendering of the MRI scan altogether?
Thank you so much.
Hello Doctor,
I am a patient with a suspected abdominal issue, that both my primary care doctor and gastroenterologist wish to further investigate.
An MRI (Enterography) was recently ordered.
Due to my own personal reasons as well as due to complex health reasons, I have chosen to decline both the use of gadolinium IV contrast, as well as the use of Mannitol and sorbitol-based oral hydrosolution (which is provided in order to cause the intestines to distend, for optimal imaging). Under no circumstances will I agree to be administered these agents.
Given this limitation, the patient, the primary doctor, the gastroenterologist, and any potential radiologist associated with the MRI, all have a choice to make. They can EITHER:
(1) encourage the MRI to proceed as a total non-contrast MRI, with no distention of the gastrointestinal tract; or,
(2) encourage the patient to consume at least some other fluid, in order to encourage maximal distention of the intestines as possible.
One of these two options makes sense medically, but the other does not.
I pose that every radiologist, when faced with this dilemma, may instinctively realize that proceeding without distending the bowels would be a detriment and a barrier to obtaining the most optimal scan possible, which is what is in the best interest of both the radiologist, and the patient, as well as all his doctors. We look to reduce the risks of lowered test sensitivity and false negatives.
…
Pursuant to this, I have had a talk with my primary care doctor. We discussed the options, and eventually, a statement signed by him was produced, instructing and encouraging both the patient and the MRI center to have the patient (myself) take juice as an oral contrast, in order to promote distention.
From his letter:
“I have discussed the pros and cons of declining contrast media with my patient. I have informed him that, despite declining a gadolinium-based contrast, that it is in our best interests to do everything we can in order to raise the image quality of the MRI scan to be produced.
“Pursuant to this, I have recommended that my patient agree to take alternative forms of contrast that will enhance the image quality, compared to a non-contrast MRI.
“For oral contrast:
‘As per studies reported, such as Effectiveness of natural oral contrast agents in magnetic resonance imaging of the bowel (2015), pineapple juice, compared to water, provides superior distention of the small bowel, which is one of our primary goals. Image artifacts are reduced as well, and image quality is significantly enhanced.
‘Moreover, as a result of the high manganese content of pineapple juice, there is evidence to show that higher concentrations of manganese compound in both the intestines and in systemic absorption/circulation, may produce slightly enhanced image quality; as per studies investigating novel use of manganese compounds positioned to eventually replace gadolinium- based compounds for MRIs, we find that ‘[the manganese element] has an ability to produce an MR signal comparable to that of GBCA’s …'
“I recommend for my patient to use pineapple juice as oral contrast if declining other forms, which has been approved and procured for the patient to bring.”
Further notes, from the source study itself, on the matter of using pineapple juice as an effective oral contrast:
“To guarantee adequate small bowel distention, the rapid physiological absorption of water needs to be delayed by using some additives to prevent or delay its absorption like Mannitol or sorbitol, but they may lead to many unwanted effects such as diarrhea, vomiting and nausea especially with mannitol. In our study, we are adherent to the aim of this work by using absolute natural contrast agents, so we did not use any additives to enhance water function.
Based on our results, Pineapple is an ideal solution that can be used as an oral contrast agent in MRI enterography. It is natural, does not need addition of chemical agents to reduce its absorption – like in cases of water-, and has good ability for bowel distention, good image quality, with no image artifacts in addition to its good taste and very minimal abdominal discomfort. “
Presentation of this letter is made to the MRI center.
…
Now, imagine that you are the radiologist. You see that the test ordered, by a gastroenterologist, is specifically to investigate a gastrointestinal issue (vis-a-vis Enterography). It has been indicated to you that the patient exercises his right to decline the specific agents of gadolinium and Mannitol/sorbitol solution and will under no condition accept those; at the same time, you also understand that the most paramount objective is to produce the most high-quality scan that is technically possible, within the circumscribed limitations posed by the patient. You are aware of the information presented on using juice such as pineapple juice (which shows most clearly on MRI scans due to high manganese content), and you are shown a letter from the patient’s main doctor supporting and encouraging its use. Finally, you are told that the patient is willing to drink this pineapple juice in order to drastically improve the scan quality.
A quick Google search online by you reveals more published studies of pineapple juice for use as oral contrast; additionally, you also find a multitude of anecdotal stories where radiologists and MRI technicians who know about pineapple juice being an excellent alternative are using it on patients who don’t want to accept the regular stuff, and they are doing so without any apparent issue.
Ultimately, you find that there is no medical reason or contraindication against its use; this is weighed against a host of beneficial effects by including its use, as it may serve a legitimate purpose by contributing value to the scan quality and results, where the alternative would be no oral fluids admitted at all, producing diagnostic results of an inferior yield.
QUESTIONS
(1) Do you allow the patient to use juice to distend the intestines for the scan? Ion practical terms, is it the best option available, given the restrictions?
(2) What would the alternatives be—and are they preferable or even acceptable?
(3) Does it make sense, from a purely practical standpoint, to discourage the proposed course of action outlined by the doctor?
(4) Given that the scan is for a potentially emergent issue, which are plausibly liable to reveal significant pathologies, does it make sense to discourage or delay rendering of the MRI scan altogether?
Thank you so much.
I am a patient with a suspected abdominal issue, that both my primary care doctor and gastroenterologist wish to further investigate.
An MRI (Enterography) was recently ordered.
Due to my own personal reasons as well as due to complex health reasons, I have chosen to decline both the use of gadolinium IV contrast, as well as the use of Mannitol and sorbitol-based oral hydrosolution (which is provided in order to cause the intestines to distend, for optimal imaging). Under no circumstances will I agree to be administered these agents.
Given this limitation, the patient, the primary doctor, the gastroenterologist, and any potential radiologist associated with the MRI, all have a choice to make. They can EITHER:
(1) encourage the MRI to proceed as a total non-contrast MRI, with no distention of the gastrointestinal tract; or,
(2) encourage the patient to consume at least some other fluid, in order to encourage maximal distention of the intestines as possible.
One of these two options makes sense medically, but the other does not.
I pose that every radiologist, when faced with this dilemma, may instinctively realize that proceeding without distending the bowels would be a detriment and a barrier to obtaining the most optimal scan possible, which is what is in the best interest of both the radiologist, and the patient, as well as all his doctors. We look to reduce the risks of lowered test sensitivity and false negatives.
…
Pursuant to this, I have had a talk with my primary care doctor. We discussed the options, and eventually, a statement signed by him was produced, instructing and encouraging both the patient and the MRI center to have the patient (myself) take juice as an oral contrast, in order to promote distention.
From his letter:
“I have discussed the pros and cons of declining contrast media with my patient. I have informed him that, despite declining a gadolinium-based contrast, that it is in our best interests to do everything we can in order to raise the image quality of the MRI scan to be produced.
“Pursuant to this, I have recommended that my patient agree to take alternative forms of contrast that will enhance the image quality, compared to a non-contrast MRI.
“For oral contrast:
‘As per studies reported, such as Effectiveness of natural oral contrast agents in magnetic resonance imaging of the bowel (2015), pineapple juice, compared to water, provides superior distention of the small bowel, which is one of our primary goals. Image artifacts are reduced as well, and image quality is significantly enhanced.
‘Moreover, as a result of the high manganese content of pineapple juice, there is evidence to show that higher concentrations of manganese compound in both the intestines and in systemic absorption/circulation, may produce slightly enhanced image quality; as per studies investigating novel use of manganese compounds positioned to eventually replace gadolinium- based compounds for MRIs, we find that ‘[the manganese element] has an ability to produce an MR signal comparable to that of GBCA’s …'
“I recommend for my patient to use pineapple juice as oral contrast if declining other forms, which has been approved and procured for the patient to bring.”
Further notes, from the source study itself, on the matter of using pineapple juice as an effective oral contrast:
“To guarantee adequate small bowel distention, the rapid physiological absorption of water needs to be delayed by using some additives to prevent or delay its absorption like Mannitol or sorbitol, but they may lead to many unwanted effects such as diarrhea, vomiting and nausea especially with mannitol. In our study, we are adherent to the aim of this work by using absolute natural contrast agents, so we did not use any additives to enhance water function.
Based on our results, Pineapple is an ideal solution that can be used as an oral contrast agent in MRI enterography. It is natural, does not need addition of chemical agents to reduce its absorption – like in cases of water-, and has good ability for bowel distention, good image quality, with no image artifacts in addition to its good taste and very minimal abdominal discomfort. “
Presentation of this letter is made to the MRI center.
…
Now, imagine that you are the radiologist. You see that the test ordered, by a gastroenterologist, is specifically to investigate a gastrointestinal issue (vis-a-vis Enterography). It has been indicated to you that the patient exercises his right to decline the specific agents of gadolinium and Mannitol/sorbitol solution and will under no condition accept those; at the same time, you also understand that the most paramount objective is to produce the most high-quality scan that is technically possible, within the circumscribed limitations posed by the patient. You are aware of the information presented on using juice such as pineapple juice (which shows most clearly on MRI scans due to high manganese content), and you are shown a letter from the patient’s main doctor supporting and encouraging its use. Finally, you are told that the patient is willing to drink this pineapple juice in order to drastically improve the scan quality.
A quick Google search online by you reveals more published studies of pineapple juice for use as oral contrast; additionally, you also find a multitude of anecdotal stories where radiologists and MRI technicians who know about pineapple juice being an excellent alternative are using it on patients who don’t want to accept the regular stuff, and they are doing so without any apparent issue.
Ultimately, you find that there is no medical reason or contraindication against its use; this is weighed against a host of beneficial effects by including its use, as it may serve a legitimate purpose by contributing value to the scan quality and results, where the alternative would be no oral fluids admitted at all, producing diagnostic results of an inferior yield.
QUESTIONS
(1) Do you allow the patient to use juice to distend the intestines for the scan? Ion practical terms, is it the best option available, given the restrictions?
(2) What would the alternatives be—and are they preferable or even acceptable?
(3) Does it make sense, from a purely practical standpoint, to discourage the proposed course of action outlined by the doctor?
(4) Given that the scan is for a potentially emergent issue, which are plausibly liable to reveal significant pathologies, does it make sense to discourage or delay rendering of the MRI scan altogether?
Thank you so much.
Brief Answer:
Pineapple juice has acceptable use for MRI enterography
Detailed Answer:
Hi,
Thanks for writing in to us.
I have read through your query in detail.
1. I shall offer pineapple juice to be ingested should a patient raise a request to be given the option of refusing other forms of conventional MRI contrast media.
2. Alternative like blueberry juice has been recommended for evaluation of the stomach and duodenum but not the rest of the small bowel.
3. I have not completely understood question 3 and what constitutes the proposed course of action outlined by the doctor. I would certainly give the patient a choice to ingest pineapple juice.
4. In such a setting I will proceed with the MRI enterography. If needed, I would recommend and additional non MRI investigation like capsule enterography should there be any doubts after doing the MRI enterography.
Regards,
Pineapple juice has acceptable use for MRI enterography
Detailed Answer:
Hi,
Thanks for writing in to us.
I have read through your query in detail.
1. I shall offer pineapple juice to be ingested should a patient raise a request to be given the option of refusing other forms of conventional MRI contrast media.
2. Alternative like blueberry juice has been recommended for evaluation of the stomach and duodenum but not the rest of the small bowel.
3. I have not completely understood question 3 and what constitutes the proposed course of action outlined by the doctor. I would certainly give the patient a choice to ingest pineapple juice.
4. In such a setting I will proceed with the MRI enterography. If needed, I would recommend and additional non MRI investigation like capsule enterography should there be any doubts after doing the MRI enterography.
Regards,
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Pineapple juice has acceptable use for MRI enterography
Detailed Answer:
Hi,
Thanks for writing in to us.
I have read through your query in detail.
1. I shall offer pineapple juice to be ingested should a patient raise a request to be given the option of refusing other forms of conventional MRI contrast media.
2. Alternative like blueberry juice has been recommended for evaluation of the stomach and duodenum but not the rest of the small bowel.
3. I have not completely understood question 3 and what constitutes the proposed course of action outlined by the doctor. I would certainly give the patient a choice to ingest pineapple juice.
4. In such a setting I will proceed with the MRI enterography. If needed, I would recommend and additional non MRI investigation like capsule enterography should there be any doubts after doing the MRI enterography.
Regards,
Pineapple juice has acceptable use for MRI enterography
Detailed Answer:
Hi,
Thanks for writing in to us.
I have read through your query in detail.
1. I shall offer pineapple juice to be ingested should a patient raise a request to be given the option of refusing other forms of conventional MRI contrast media.
2. Alternative like blueberry juice has been recommended for evaluation of the stomach and duodenum but not the rest of the small bowel.
3. I have not completely understood question 3 and what constitutes the proposed course of action outlined by the doctor. I would certainly give the patient a choice to ingest pineapple juice.
4. In such a setting I will proceed with the MRI enterography. If needed, I would recommend and additional non MRI investigation like capsule enterography should there be any doubts after doing the MRI enterography.
Regards,
Above answer was peer-reviewed by :
Dr. Kampana
Hello Dr Chail!
Good to see a response from you.
You are somewhat familiar with my medical backstory.
I've had difficulties arranging an MRI scan here, and working out the details. The MRI center wanted to decline service because of my reluctance to take the traditional xylitol/sorbitol and gadolinium forms of contrast.
Eventually, I got my way--and was able to proceed with non-IV-contrast MRE, with pineapple juice as the oral contrast.
About 1.75 L of oral contrast were consumed.
Finally, the report has been released.
However, the report has glaring shortcomings. I am also extremely certain that the radiologists here missed the picture. I would be very eager to ask you for a second opinion.
It could very well save my life or alter the course of my potential treatment.
Allow me to briefly describe (more info will be given soon):
For the last year or so, I have been living with a chronic acute abdomen. This is not officially medically diagnosed; however, it has been masked by the effects of a chemical that I have been poisoned with, which almost completely eliminates pain sensation, inflammatory responses, and immune responses within the system.
...
For the past year, nearly everytime I have swallowed beverages, I would feel the beverage almost immediately begin to accumulate at the area of my pelvic floor.
More recently, it has become obvious to me that intraperitoneal air is also present, particularly when I take in air through the mouth into the GI tract--it can be felt escaping, and moving to where the sides of my ribs are. When both air and fluids are taken in, the fluids can be felt smacking internally against the abdominal walls by the ribs.
...
My plan to produce a positive MRE was as follows:
To consume the positive oral contrast agent (high T1 and high T2 signal) of pineapple juice, prior to the MRI, and to also swallow a good bit of air along with the juice, each time I swallowed.
Then, position myself before the MRI scan in order to have the air bubbles position itself most closely to where it may be likely to show in the peritoneum, outside of the physical boundaries of the gastrointestinal tract.
Furthermore, because the pineapple juice is also leaving the GI tract, its high signal should be received from the peritoneum, IF this pineapple juice really were to escape the GI tract. (In normal cases, someone drinking pineapple juice would reasonably be expected to produce highlighted, brightened color and strengthened signal only from within the boundaries of the GI tract and small bowel.
...
The results are back. I have quickly examined them on CD, and find hints to show that my understanding of my own internal situation has indeed been correct! However, the radiologists here saw no such things, as they had no even taken the time to carefully examine.
I am kindly requesting that the following analysis of my MRI scans be made:
(1) To find any evidence whatsoever that this pineapple juice has left the boundaries of the GI tract, and has poured into the peritoneal space of the torso; this can be done by comparing where the high-signal fluid has gone, compared to where there would be only gry, darkened areas from water and non-pineapple-juice-filled volumes.
(2) Perhaps most importantly: To find any evidence that there is free air residing in ANY place that is outside of the digestive tract. Upon initial examination, there appears to be much air in the scan, however, the majority of this air is displayed within the apparent boundaries of the organs and bowels. However, if even ONE section of air present can be shown to be residing outside of the digestive boundaries, this would be enough evidence to support the retroactive occurrence of a perforation at least at some point in the past.
(3) To find any evidence of a physical perforation, anywhere along the GI tract, that does NOT manifest with inflammation, but rather, more discreetly manifests as a disconnection of continuous membrane.
...
I am thinking of the most efficient way to send the entire contents of the CD-ROM that I have been given. Are you aware of any easy ways to transmit the full scan data to you, that I have on here? Perhaps I can use a program like DAEMON TOOLS to extract the .iso file, and you can then mount the .iso image on a virtual drive using a similar tool like DAEMON TOOLS, or any other method?
Please let me know. I will look into this very shortly, and shall look to make this available to you as soon as possible.
Thank you, Dr Chail, for your time! I trust that with extremely careful, diligent examination, you may be able to find strong evidence consistent with what I have been presenting. I am in nearly desperate need of proof, to provide to the very cynical medical community around me.
-Jon
Good to see a response from you.
You are somewhat familiar with my medical backstory.
I've had difficulties arranging an MRI scan here, and working out the details. The MRI center wanted to decline service because of my reluctance to take the traditional xylitol/sorbitol and gadolinium forms of contrast.
Eventually, I got my way--and was able to proceed with non-IV-contrast MRE, with pineapple juice as the oral contrast.
About 1.75 L of oral contrast were consumed.
Finally, the report has been released.
However, the report has glaring shortcomings. I am also extremely certain that the radiologists here missed the picture. I would be very eager to ask you for a second opinion.
It could very well save my life or alter the course of my potential treatment.
Allow me to briefly describe (more info will be given soon):
For the last year or so, I have been living with a chronic acute abdomen. This is not officially medically diagnosed; however, it has been masked by the effects of a chemical that I have been poisoned with, which almost completely eliminates pain sensation, inflammatory responses, and immune responses within the system.
...
For the past year, nearly everytime I have swallowed beverages, I would feel the beverage almost immediately begin to accumulate at the area of my pelvic floor.
More recently, it has become obvious to me that intraperitoneal air is also present, particularly when I take in air through the mouth into the GI tract--it can be felt escaping, and moving to where the sides of my ribs are. When both air and fluids are taken in, the fluids can be felt smacking internally against the abdominal walls by the ribs.
...
My plan to produce a positive MRE was as follows:
To consume the positive oral contrast agent (high T1 and high T2 signal) of pineapple juice, prior to the MRI, and to also swallow a good bit of air along with the juice, each time I swallowed.
Then, position myself before the MRI scan in order to have the air bubbles position itself most closely to where it may be likely to show in the peritoneum, outside of the physical boundaries of the gastrointestinal tract.
Furthermore, because the pineapple juice is also leaving the GI tract, its high signal should be received from the peritoneum, IF this pineapple juice really were to escape the GI tract. (In normal cases, someone drinking pineapple juice would reasonably be expected to produce highlighted, brightened color and strengthened signal only from within the boundaries of the GI tract and small bowel.
...
The results are back. I have quickly examined them on CD, and find hints to show that my understanding of my own internal situation has indeed been correct! However, the radiologists here saw no such things, as they had no even taken the time to carefully examine.
I am kindly requesting that the following analysis of my MRI scans be made:
(1) To find any evidence whatsoever that this pineapple juice has left the boundaries of the GI tract, and has poured into the peritoneal space of the torso; this can be done by comparing where the high-signal fluid has gone, compared to where there would be only gry, darkened areas from water and non-pineapple-juice-filled volumes.
(2) Perhaps most importantly: To find any evidence that there is free air residing in ANY place that is outside of the digestive tract. Upon initial examination, there appears to be much air in the scan, however, the majority of this air is displayed within the apparent boundaries of the organs and bowels. However, if even ONE section of air present can be shown to be residing outside of the digestive boundaries, this would be enough evidence to support the retroactive occurrence of a perforation at least at some point in the past.
(3) To find any evidence of a physical perforation, anywhere along the GI tract, that does NOT manifest with inflammation, but rather, more discreetly manifests as a disconnection of continuous membrane.
...
I am thinking of the most efficient way to send the entire contents of the CD-ROM that I have been given. Are you aware of any easy ways to transmit the full scan data to you, that I have on here? Perhaps I can use a program like DAEMON TOOLS to extract the .iso file, and you can then mount the .iso image on a virtual drive using a similar tool like DAEMON TOOLS, or any other method?
Please let me know. I will look into this very shortly, and shall look to make this available to you as soon as possible.
Thank you, Dr Chail, for your time! I trust that with extremely careful, diligent examination, you may be able to find strong evidence consistent with what I have been presenting. I am in nearly desperate need of proof, to provide to the very cynical medical community around me.
-Jon
Hello Dr Chail!
Good to see a response from you.
You are somewhat familiar with my medical backstory.
I've had difficulties arranging an MRI scan here, and working out the details. The MRI center wanted to decline service because of my reluctance to take the traditional xylitol/sorbitol and gadolinium forms of contrast.
Eventually, I got my way--and was able to proceed with non-IV-contrast MRE, with pineapple juice as the oral contrast.
About 1.75 L of oral contrast were consumed.
Finally, the report has been released.
However, the report has glaring shortcomings. I am also extremely certain that the radiologists here missed the picture. I would be very eager to ask you for a second opinion.
It could very well save my life or alter the course of my potential treatment.
Allow me to briefly describe (more info will be given soon):
For the last year or so, I have been living with a chronic acute abdomen. This is not officially medically diagnosed; however, it has been masked by the effects of a chemical that I have been poisoned with, which almost completely eliminates pain sensation, inflammatory responses, and immune responses within the system.
...
For the past year, nearly everytime I have swallowed beverages, I would feel the beverage almost immediately begin to accumulate at the area of my pelvic floor.
More recently, it has become obvious to me that intraperitoneal air is also present, particularly when I take in air through the mouth into the GI tract--it can be felt escaping, and moving to where the sides of my ribs are. When both air and fluids are taken in, the fluids can be felt smacking internally against the abdominal walls by the ribs.
...
My plan to produce a positive MRE was as follows:
To consume the positive oral contrast agent (high T1 and high T2 signal) of pineapple juice, prior to the MRI, and to also swallow a good bit of air along with the juice, each time I swallowed.
Then, position myself before the MRI scan in order to have the air bubbles position itself most closely to where it may be likely to show in the peritoneum, outside of the physical boundaries of the gastrointestinal tract.
Furthermore, because the pineapple juice is also leaving the GI tract, its high signal should be received from the peritoneum, IF this pineapple juice really were to escape the GI tract. (In normal cases, someone drinking pineapple juice would reasonably be expected to produce highlighted, brightened color and strengthened signal only from within the boundaries of the GI tract and small bowel.
...
The results are back. I have quickly examined them on CD, and find hints to show that my understanding of my own internal situation has indeed been correct! However, the radiologists here saw no such things, as they had no even taken the time to carefully examine.
I am kindly requesting that the following analysis of my MRI scans be made:
(1) To find any evidence whatsoever that this pineapple juice has left the boundaries of the GI tract, and has poured into the peritoneal space of the torso; this can be done by comparing where the high-signal fluid has gone, compared to where there would be only gry, darkened areas from water and non-pineapple-juice-filled volumes.
(2) Perhaps most importantly: To find any evidence that there is free air residing in ANY place that is outside of the digestive tract. Upon initial examination, there appears to be much air in the scan, however, the majority of this air is displayed within the apparent boundaries of the organs and bowels. However, if even ONE section of air present can be shown to be residing outside of the digestive boundaries, this would be enough evidence to support the retroactive occurrence of a perforation at least at some point in the past.
(3) To find any evidence of a physical perforation, anywhere along the GI tract, that does NOT manifest with inflammation, but rather, more discreetly manifests as a disconnection of continuous membrane.
...
I am thinking of the most efficient way to send the entire contents of the CD-ROM that I have been given. Are you aware of any easy ways to transmit the full scan data to you, that I have on here? Perhaps I can use a program like DAEMON TOOLS to extract the .iso file, and you can then mount the .iso image on a virtual drive using a similar tool like DAEMON TOOLS, or any other method?
Please let me know. I will look into this very shortly, and shall look to make this available to you as soon as possible.
Thank you, Dr Chail, for your time! I trust that with extremely careful, diligent examination, you may be able to find strong evidence consistent with what I have been presenting. I am in nearly desperate need of proof, to provide to the very cynical medical community around me.
-Jon
Good to see a response from you.
You are somewhat familiar with my medical backstory.
I've had difficulties arranging an MRI scan here, and working out the details. The MRI center wanted to decline service because of my reluctance to take the traditional xylitol/sorbitol and gadolinium forms of contrast.
Eventually, I got my way--and was able to proceed with non-IV-contrast MRE, with pineapple juice as the oral contrast.
About 1.75 L of oral contrast were consumed.
Finally, the report has been released.
However, the report has glaring shortcomings. I am also extremely certain that the radiologists here missed the picture. I would be very eager to ask you for a second opinion.
It could very well save my life or alter the course of my potential treatment.
Allow me to briefly describe (more info will be given soon):
For the last year or so, I have been living with a chronic acute abdomen. This is not officially medically diagnosed; however, it has been masked by the effects of a chemical that I have been poisoned with, which almost completely eliminates pain sensation, inflammatory responses, and immune responses within the system.
...
For the past year, nearly everytime I have swallowed beverages, I would feel the beverage almost immediately begin to accumulate at the area of my pelvic floor.
More recently, it has become obvious to me that intraperitoneal air is also present, particularly when I take in air through the mouth into the GI tract--it can be felt escaping, and moving to where the sides of my ribs are. When both air and fluids are taken in, the fluids can be felt smacking internally against the abdominal walls by the ribs.
...
My plan to produce a positive MRE was as follows:
To consume the positive oral contrast agent (high T1 and high T2 signal) of pineapple juice, prior to the MRI, and to also swallow a good bit of air along with the juice, each time I swallowed.
Then, position myself before the MRI scan in order to have the air bubbles position itself most closely to where it may be likely to show in the peritoneum, outside of the physical boundaries of the gastrointestinal tract.
Furthermore, because the pineapple juice is also leaving the GI tract, its high signal should be received from the peritoneum, IF this pineapple juice really were to escape the GI tract. (In normal cases, someone drinking pineapple juice would reasonably be expected to produce highlighted, brightened color and strengthened signal only from within the boundaries of the GI tract and small bowel.
...
The results are back. I have quickly examined them on CD, and find hints to show that my understanding of my own internal situation has indeed been correct! However, the radiologists here saw no such things, as they had no even taken the time to carefully examine.
I am kindly requesting that the following analysis of my MRI scans be made:
(1) To find any evidence whatsoever that this pineapple juice has left the boundaries of the GI tract, and has poured into the peritoneal space of the torso; this can be done by comparing where the high-signal fluid has gone, compared to where there would be only gry, darkened areas from water and non-pineapple-juice-filled volumes.
(2) Perhaps most importantly: To find any evidence that there is free air residing in ANY place that is outside of the digestive tract. Upon initial examination, there appears to be much air in the scan, however, the majority of this air is displayed within the apparent boundaries of the organs and bowels. However, if even ONE section of air present can be shown to be residing outside of the digestive boundaries, this would be enough evidence to support the retroactive occurrence of a perforation at least at some point in the past.
(3) To find any evidence of a physical perforation, anywhere along the GI tract, that does NOT manifest with inflammation, but rather, more discreetly manifests as a disconnection of continuous membrane.
...
I am thinking of the most efficient way to send the entire contents of the CD-ROM that I have been given. Are you aware of any easy ways to transmit the full scan data to you, that I have on here? Perhaps I can use a program like DAEMON TOOLS to extract the .iso file, and you can then mount the .iso image on a virtual drive using a similar tool like DAEMON TOOLS, or any other method?
Please let me know. I will look into this very shortly, and shall look to make this available to you as soon as possible.
Thank you, Dr Chail, for your time! I trust that with extremely careful, diligent examination, you may be able to find strong evidence consistent with what I have been presenting. I am in nearly desperate need of proof, to provide to the very cynical medical community around me.
-Jon
Hi Doctor,
Just to follow up:
I compressed the contents of the MRI CD into a zip file, and uploaded this file onto a file upload site.
This file can be downloaded here:
https://ufile.io/d0leu
Once the zip file is opened, it should contain seven files, including one folder with many additional files inside. These seven files are the exact same files that are the contents of the CD, when opened (except for the autorun, I think.)
...
Alternately, the front of my CD has a label that states this:
"Physicians only -- To view your patients' images and reports online, visit:
www.NYRPConnect.com
www.LenRadConnect.com"
Patient info:
XXXXXXX XXXXXXX P
(DOB: 09-09-1988)
MRN: 0000R
MR Enterograohy WO - Abdomen (03-07-2019)
...
Thank you so much.
In a follow-up message, shortly, I will also provide one additional piece of information/analysis, that may be important; it seems it was overlooked in the report (which contains multiple errors, to be discussed soon.)
Just to follow up:
I compressed the contents of the MRI CD into a zip file, and uploaded this file onto a file upload site.
This file can be downloaded here:
https://ufile.io/d0leu
Once the zip file is opened, it should contain seven files, including one folder with many additional files inside. These seven files are the exact same files that are the contents of the CD, when opened (except for the autorun, I think.)
...
Alternately, the front of my CD has a label that states this:
"Physicians only -- To view your patients' images and reports online, visit:
www.NYRPConnect.com
www.LenRadConnect.com"
Patient info:
XXXXXXX XXXXXXX P
(DOB: 09-09-1988)
MRN: 0000R
MR Enterograohy WO - Abdomen (03-07-2019)
...
Thank you so much.
In a follow-up message, shortly, I will also provide one additional piece of information/analysis, that may be important; it seems it was overlooked in the report (which contains multiple errors, to be discussed soon.)
Hi Doctor,
Just to follow up:
I compressed the contents of the MRI CD into a zip file, and uploaded this file onto a file upload site.
This file can be downloaded here:
https://ufile.io/d0leu
Once the zip file is opened, it should contain seven files, including one folder with many additional files inside. These seven files are the exact same files that are the contents of the CD, when opened (except for the autorun, I think.)
...
Alternately, the front of my CD has a label that states this:
"Physicians only -- To view your patients' images and reports online, visit:
www.NYRPConnect.com
www.LenRadConnect.com"
Patient info:
XXXXXXX XXXXXXX P
(DOB: 09-09-1988)
MRN: 0000R
MR Enterograohy WO - Abdomen (03-07-2019)
...
Thank you so much.
In a follow-up message, shortly, I will also provide one additional piece of information/analysis, that may be important; it seems it was overlooked in the report (which contains multiple errors, to be discussed soon.)
Just to follow up:
I compressed the contents of the MRI CD into a zip file, and uploaded this file onto a file upload site.
This file can be downloaded here:
https://ufile.io/d0leu
Once the zip file is opened, it should contain seven files, including one folder with many additional files inside. These seven files are the exact same files that are the contents of the CD, when opened (except for the autorun, I think.)
...
Alternately, the front of my CD has a label that states this:
"Physicians only -- To view your patients' images and reports online, visit:
www.NYRPConnect.com
www.LenRadConnect.com"
Patient info:
XXXXXXX XXXXXXX P
(DOB: 09-09-1988)
MRN: 0000R
MR Enterograohy WO - Abdomen (03-07-2019)
...
Thank you so much.
In a follow-up message, shortly, I will also provide one additional piece of information/analysis, that may be important; it seems it was overlooked in the report (which contains multiple errors, to be discussed soon.)
One additional point to make.
To pose a question: in the case of an intestinal perforation, would we expect to see intestines/bowels that remain very well distended? Or would we expect to see bowel segments that remain suspiciously collapsed, despite the large amounts of fluids consumed for the test?
I think it is nearly self-evident and common sense, to see that the latter situation would be the case.
So what we need to do is to assess whether such an anomaly was produced in my case.
It seems that it clearly was.
Let us check this link and study for information on how well pineapple juice keeps the bowels distended.
X
In this study, in multiple places, it is discussed how the fluid of pineapple juice is able to keep the bowels distended without the need for mannitol or Sorbitol.
Furthermore, it states that by using only 1,000 mL of juice, the bowels were well distended in all cases. The average measurement of distention is provided in the study; it is also assumed that the variance or deviation of this figure is small, as it is implied that this 1L of juice was able to maintain good quality in ALL patientd in the study.
Now, if 1,000mL is enough to do the job, one would easily assume that the amount I took, which was nearly double (1,750 mL) would produce even greater distention, and also keep the bowels distended for significantly longer.
And yet, the report notes, that there were ***severe limitations of my small bowel, because MOST SEGMENTS WERE COMPLETELY COLLAPSED!***
Well how is this possible! Where did the juice go? I did not vomit this juice back out, and it would not have been absorbed so quickly.
I think we must begin to test for the hypothesis that pineapple juice, and free air, have escaped into the peritoneum, leaving the bowels collapsed.
For this is what I've been feeling for several months--even to the point that when I drink an ice-cold beverage, a minute later, my scrotum becomes ice cold to the touch.
To pose a question: in the case of an intestinal perforation, would we expect to see intestines/bowels that remain very well distended? Or would we expect to see bowel segments that remain suspiciously collapsed, despite the large amounts of fluids consumed for the test?
I think it is nearly self-evident and common sense, to see that the latter situation would be the case.
So what we need to do is to assess whether such an anomaly was produced in my case.
It seems that it clearly was.
Let us check this link and study for information on how well pineapple juice keeps the bowels distended.
X
In this study, in multiple places, it is discussed how the fluid of pineapple juice is able to keep the bowels distended without the need for mannitol or Sorbitol.
Furthermore, it states that by using only 1,000 mL of juice, the bowels were well distended in all cases. The average measurement of distention is provided in the study; it is also assumed that the variance or deviation of this figure is small, as it is implied that this 1L of juice was able to maintain good quality in ALL patientd in the study.
Now, if 1,000mL is enough to do the job, one would easily assume that the amount I took, which was nearly double (1,750 mL) would produce even greater distention, and also keep the bowels distended for significantly longer.
And yet, the report notes, that there were ***severe limitations of my small bowel, because MOST SEGMENTS WERE COMPLETELY COLLAPSED!***
Well how is this possible! Where did the juice go? I did not vomit this juice back out, and it would not have been absorbed so quickly.
I think we must begin to test for the hypothesis that pineapple juice, and free air, have escaped into the peritoneum, leaving the bowels collapsed.
For this is what I've been feeling for several months--even to the point that when I drink an ice-cold beverage, a minute later, my scrotum becomes ice cold to the touch.
One additional point to make.
To pose a question: in the case of an intestinal perforation, would we expect to see intestines/bowels that remain very well distended? Or would we expect to see bowel segments that remain suspiciously collapsed, despite the large amounts of fluids consumed for the test?
I think it is nearly self-evident and common sense, to see that the latter situation would be the case.
So what we need to do is to assess whether such an anomaly was produced in my case.
It seems that it clearly was.
Let us check this link and study for information on how well pineapple juice keeps the bowels distended.
X
In this study, in multiple places, it is discussed how the fluid of pineapple juice is able to keep the bowels distended without the need for mannitol or Sorbitol.
Furthermore, it states that by using only 1,000 mL of juice, the bowels were well distended in all cases. The average measurement of distention is provided in the study; it is also assumed that the variance or deviation of this figure is small, as it is implied that this 1L of juice was able to maintain good quality in ALL patientd in the study.
Now, if 1,000mL is enough to do the job, one would easily assume that the amount I took, which was nearly double (1,750 mL) would produce even greater distention, and also keep the bowels distended for significantly longer.
And yet, the report notes, that there were ***severe limitations of my small bowel, because MOST SEGMENTS WERE COMPLETELY COLLAPSED!***
Well how is this possible! Where did the juice go? I did not vomit this juice back out, and it would not have been absorbed so quickly.
I think we must begin to test for the hypothesis that pineapple juice, and free air, have escaped into the peritoneum, leaving the bowels collapsed.
For this is what I've been feeling for several months--even to the point that when I drink an ice-cold beverage, a minute later, my scrotum becomes ice cold to the touch.
To pose a question: in the case of an intestinal perforation, would we expect to see intestines/bowels that remain very well distended? Or would we expect to see bowel segments that remain suspiciously collapsed, despite the large amounts of fluids consumed for the test?
I think it is nearly self-evident and common sense, to see that the latter situation would be the case.
So what we need to do is to assess whether such an anomaly was produced in my case.
It seems that it clearly was.
Let us check this link and study for information on how well pineapple juice keeps the bowels distended.
X
In this study, in multiple places, it is discussed how the fluid of pineapple juice is able to keep the bowels distended without the need for mannitol or Sorbitol.
Furthermore, it states that by using only 1,000 mL of juice, the bowels were well distended in all cases. The average measurement of distention is provided in the study; it is also assumed that the variance or deviation of this figure is small, as it is implied that this 1L of juice was able to maintain good quality in ALL patientd in the study.
Now, if 1,000mL is enough to do the job, one would easily assume that the amount I took, which was nearly double (1,750 mL) would produce even greater distention, and also keep the bowels distended for significantly longer.
And yet, the report notes, that there were ***severe limitations of my small bowel, because MOST SEGMENTS WERE COMPLETELY COLLAPSED!***
Well how is this possible! Where did the juice go? I did not vomit this juice back out, and it would not have been absorbed so quickly.
I think we must begin to test for the hypothesis that pineapple juice, and free air, have escaped into the peritoneum, leaving the bowels collapsed.
For this is what I've been feeling for several months--even to the point that when I drink an ice-cold beverage, a minute later, my scrotum becomes ice cold to the touch.
(https://www.sciencedirect.com/science/article/pii/S0000X0000)
(https://www.sciencedirect.com/science/article/pii/S0000X0000)
Brief Answer:
Sorry, unable to download images. Request for another link
Detailed Answer:
Hi,
Thanks for writing in.
I would surely like to view the MRI enterography images at the earliest.
Have been trying to download the images but somehow the download is not starting at my end.
Can I request you to please upload to another file sharing facility like Dropbox or Google drive and share the links.
Regards,
Sorry, unable to download images. Request for another link
Detailed Answer:
Hi,
Thanks for writing in.
I would surely like to view the MRI enterography images at the earliest.
Have been trying to download the images but somehow the download is not starting at my end.
Can I request you to please upload to another file sharing facility like Dropbox or Google drive and share the links.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Sorry, unable to download images. Request for another link
Detailed Answer:
Hi,
Thanks for writing in.
I would surely like to view the MRI enterography images at the earliest.
Have been trying to download the images but somehow the download is not starting at my end.
Can I request you to please upload to another file sharing facility like Dropbox or Google drive and share the links.
Regards,
Sorry, unable to download images. Request for another link
Detailed Answer:
Hi,
Thanks for writing in.
I would surely like to view the MRI enterography images at the earliest.
Have been trying to download the images but somehow the download is not starting at my end.
Can I request you to please upload to another file sharing facility like Dropbox or Google drive and share the links.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I will try to get to a computer with a CD drive to extract the files once again, and use a different service, within the next 24 hours or so.
In the mean time, if you are able to access my info and files via the CD label information and websites that I referenced, this would be great too.
Please let me know. I will provide the upload/download link as soon as I can.
In the mean time, if you are able to access my info and files via the CD label information and websites that I referenced, this would be great too.
Please let me know. I will provide the upload/download link as soon as I can.
I will try to get to a computer with a CD drive to extract the files once again, and use a different service, within the next 24 hours or so.
In the mean time, if you are able to access my info and files via the CD label information and websites that I referenced, this would be great too.
Please let me know. I will provide the upload/download link as soon as I can.
In the mean time, if you are able to access my info and files via the CD label information and websites that I referenced, this would be great too.
Please let me know. I will provide the upload/download link as soon as I can.
The link:
https://drive.google.com/file/d/1HqL_trzrbWOsmCi5MuRYFRkNud16AqLO/view?usp=drivesdk
https://drive.google.com/file/d/1HqL_trzrbWOsmCi5MuRYFRkNud16AqLO/view?usp=drivesdk
The link:
https://drive.google.com/file/d/1HqL_trzrbWOsmCi5MuRYFRkNud16AqLO/view?usp=drivesdk
https://drive.google.com/file/d/1HqL_trzrbWOsmCi5MuRYFRkNud16AqLO/view?usp=drivesdk
Brief Answer:
No large air pockets, need to review with more detailed information
Detailed Answer:
Hi,
Thanks for writing in and sharing the link.
I have viewed the images. Even though there are certain limitations, the study of the small bowel is satisfactory.
There is no spillage of the oral contents to the surrounding area of thebowel
However the stomach and large bowel are bit over distended abnd this can be due to the fluid intake and dynamics of your system.
MRI does have limitations in the visualisation of small amounts of free air. This is because MRI scan has movement artefacts due to increased scan times. There is no large pocket of free air.
At the moment I would like to know the exact area of discomfort so that I can review your images once again keeping in mind your symptoms and double check and bowel perforation or free air in the area.
Regards,
No large air pockets, need to review with more detailed information
Detailed Answer:
Hi,
Thanks for writing in and sharing the link.
I have viewed the images. Even though there are certain limitations, the study of the small bowel is satisfactory.
There is no spillage of the oral contents to the surrounding area of thebowel
However the stomach and large bowel are bit over distended abnd this can be due to the fluid intake and dynamics of your system.
MRI does have limitations in the visualisation of small amounts of free air. This is because MRI scan has movement artefacts due to increased scan times. There is no large pocket of free air.
At the moment I would like to know the exact area of discomfort so that I can review your images once again keeping in mind your symptoms and double check and bowel perforation or free air in the area.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
No large air pockets, need to review with more detailed information
Detailed Answer:
Hi,
Thanks for writing in and sharing the link.
I have viewed the images. Even though there are certain limitations, the study of the small bowel is satisfactory.
There is no spillage of the oral contents to the surrounding area of thebowel
However the stomach and large bowel are bit over distended abnd this can be due to the fluid intake and dynamics of your system.
MRI does have limitations in the visualisation of small amounts of free air. This is because MRI scan has movement artefacts due to increased scan times. There is no large pocket of free air.
At the moment I would like to know the exact area of discomfort so that I can review your images once again keeping in mind your symptoms and double check and bowel perforation or free air in the area.
Regards,
No large air pockets, need to review with more detailed information
Detailed Answer:
Hi,
Thanks for writing in and sharing the link.
I have viewed the images. Even though there are certain limitations, the study of the small bowel is satisfactory.
There is no spillage of the oral contents to the surrounding area of thebowel
However the stomach and large bowel are bit over distended abnd this can be due to the fluid intake and dynamics of your system.
MRI does have limitations in the visualisation of small amounts of free air. This is because MRI scan has movement artefacts due to increased scan times. There is no large pocket of free air.
At the moment I would like to know the exact area of discomfort so that I can review your images once again keeping in mind your symptoms and double check and bowel perforation or free air in the area.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Most of the free air that I feel tends to pool in my upper-left quadrant--usually under the lower to middle ribs on my left side, when I am lying down.
I can say from experience, that it is *for sure* that fluids have, regularly, been spilling out into the peritoneal space. it is just a matter of getting the proper test done at the right time to catch it.
Yes, I would very much appreciate it if you could find any additional evidence.
Are you able to see increased brightness on T2 weighted images of the inter-organ space on the cross-sectional pictures, pretty much everything outside of the kidneys? It the strength of signal coming from there higher than you may otherwise expect from a patient? Might this be any indication, too?
I can say from experience, that it is *for sure* that fluids have, regularly, been spilling out into the peritoneal space. it is just a matter of getting the proper test done at the right time to catch it.
Yes, I would very much appreciate it if you could find any additional evidence.
Are you able to see increased brightness on T2 weighted images of the inter-organ space on the cross-sectional pictures, pretty much everything outside of the kidneys? It the strength of signal coming from there higher than you may otherwise expect from a patient? Might this be any indication, too?
Most of the free air that I feel tends to pool in my upper-left quadrant--usually under the lower to middle ribs on my left side, when I am lying down.
I can say from experience, that it is *for sure* that fluids have, regularly, been spilling out into the peritoneal space. it is just a matter of getting the proper test done at the right time to catch it.
Yes, I would very much appreciate it if you could find any additional evidence.
Are you able to see increased brightness on T2 weighted images of the inter-organ space on the cross-sectional pictures, pretty much everything outside of the kidneys? It the strength of signal coming from there higher than you may otherwise expect from a patient? Might this be any indication, too?
I can say from experience, that it is *for sure* that fluids have, regularly, been spilling out into the peritoneal space. it is just a matter of getting the proper test done at the right time to catch it.
Yes, I would very much appreciate it if you could find any additional evidence.
Are you able to see increased brightness on T2 weighted images of the inter-organ space on the cross-sectional pictures, pretty much everything outside of the kidneys? It the strength of signal coming from there higher than you may otherwise expect from a patient? Might this be any indication, too?
Yes. Please focus on upper-left quadrant if possible.
When I examined, I noticed that the range rarely got high enough, and in cases where it got close, the resolution and clarity seems to be poor. I know the truth of what I have been feeling and living with, but the MRI's rendering offers poor clarity, and some unfortunate ambiguity, at least from my own untrained eye.
Am still hoping you may be able to catch any signs of abnormality. Once again, I think signal strength from pineapple juice may bear hints in some of the cross sections, by beholding areas that seem "brighter" than they otherwise should be.
Thank you for your dedication, and your energy and time, Doctor
When I examined, I noticed that the range rarely got high enough, and in cases where it got close, the resolution and clarity seems to be poor. I know the truth of what I have been feeling and living with, but the MRI's rendering offers poor clarity, and some unfortunate ambiguity, at least from my own untrained eye.
Am still hoping you may be able to catch any signs of abnormality. Once again, I think signal strength from pineapple juice may bear hints in some of the cross sections, by beholding areas that seem "brighter" than they otherwise should be.
Thank you for your dedication, and your energy and time, Doctor
Yes. Please focus on upper-left quadrant if possible.
When I examined, I noticed that the range rarely got high enough, and in cases where it got close, the resolution and clarity seems to be poor. I know the truth of what I have been feeling and living with, but the MRI's rendering offers poor clarity, and some unfortunate ambiguity, at least from my own untrained eye.
Am still hoping you may be able to catch any signs of abnormality. Once again, I think signal strength from pineapple juice may bear hints in some of the cross sections, by beholding areas that seem "brighter" than they otherwise should be.
Thank you for your dedication, and your energy and time, Doctor
When I examined, I noticed that the range rarely got high enough, and in cases where it got close, the resolution and clarity seems to be poor. I know the truth of what I have been feeling and living with, but the MRI's rendering offers poor clarity, and some unfortunate ambiguity, at least from my own untrained eye.
Am still hoping you may be able to catch any signs of abnormality. Once again, I think signal strength from pineapple juice may bear hints in some of the cross sections, by beholding areas that seem "brighter" than they otherwise should be.
Thank you for your dedication, and your energy and time, Doctor
Brief Answer:
There is quick release of fluids from the small intestines.
Detailed Answer:
Hi,
Thanks for writing in to us.
There is a 12 mm round soft tissue area near the spleen in the right upper quadrant area and is a likely splenunculus.
On carefully examining the images done I find that the later images show a significant amount of air in the small bowel. This means that the fluid is exiting the intestines and air is taking the space. So there is a quick mechanism by which the fluid is getting out of the small intestine and letting air take the space. This again can be a physiological variation of the way your bowels are functioning. It can also be a feature of hypermotility of the bowel.
The fat between the kidney and spleen is intact in the given images.
Please do let me know your thoughts.
Regards,
There is quick release of fluids from the small intestines.
Detailed Answer:
Hi,
Thanks for writing in to us.
There is a 12 mm round soft tissue area near the spleen in the right upper quadrant area and is a likely splenunculus.
On carefully examining the images done I find that the later images show a significant amount of air in the small bowel. This means that the fluid is exiting the intestines and air is taking the space. So there is a quick mechanism by which the fluid is getting out of the small intestine and letting air take the space. This again can be a physiological variation of the way your bowels are functioning. It can also be a feature of hypermotility of the bowel.
The fat between the kidney and spleen is intact in the given images.
Please do let me know your thoughts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
There is quick release of fluids from the small intestines.
Detailed Answer:
Hi,
Thanks for writing in to us.
There is a 12 mm round soft tissue area near the spleen in the right upper quadrant area and is a likely splenunculus.
On carefully examining the images done I find that the later images show a significant amount of air in the small bowel. This means that the fluid is exiting the intestines and air is taking the space. So there is a quick mechanism by which the fluid is getting out of the small intestine and letting air take the space. This again can be a physiological variation of the way your bowels are functioning. It can also be a feature of hypermotility of the bowel.
The fat between the kidney and spleen is intact in the given images.
Please do let me know your thoughts.
Regards,
There is quick release of fluids from the small intestines.
Detailed Answer:
Hi,
Thanks for writing in to us.
There is a 12 mm round soft tissue area near the spleen in the right upper quadrant area and is a likely splenunculus.
On carefully examining the images done I find that the later images show a significant amount of air in the small bowel. This means that the fluid is exiting the intestines and air is taking the space. So there is a quick mechanism by which the fluid is getting out of the small intestine and letting air take the space. This again can be a physiological variation of the way your bowels are functioning. It can also be a feature of hypermotility of the bowel.
The fat between the kidney and spleen is intact in the given images.
Please do let me know your thoughts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
As far as I am aware, the main source of air within the small bowels was introduced by myself intentionally, which is air that I swallowed along with the pineapple juice during consumption just prior to the MRI scan, done intentionally with the purpose of providing any radiologist with the opportunity to examine whether any percentage of this air was able to leave the small bowel via any hidden, small or masked perforations there, and flow out into the general inter-organ / peritoneal space.
I do agree with your finding that fluid is in fact exiting the intestines. Besides my own subjective reporting of the sensations of fluid leaving the intestine, it is also radiologically suspicious to see that, according to the official report, most of my smal bowel segments were collapsed after drinking 1.75 L of pineapple juice, while most studies show that 1.00 L of pneapple juice is sufficient to keep all bowel segments distended in all subjects tested.
This does, in fact, imply strongly that the fluid has, in fact, left the bowel.
Only one of two things may be happening to it: (1) the fluid is more rapidly absorbed into the system, more rapidly than in any other normal patient; however, there is no evidence to support that this would be the case for me.
(2) the fluid has left the bowels via a non-inflamed, hidden perforation, and has MIXED IN with the peritoneal fluids of the peritoneum, which results in a composite fluid of serous fluid mixed with pineapple juice. This has been my subjective perception f what has been going on, and has been consistently been reported for about a year. It is therefore no coincidence that we see findings involving *fluids escaping from the small bowels*, from a patient who makes it clear that he has been experiencing fluids leaving his small bowels.
Doctor, please tell me--with the conclusion now reached that fluids do seem to be leaving the small bowels in a highly-unusual manner, what conclusion may we be able to reach by implication?
Are you able to make the implicit or presumptive diagnosis or medical opinion that there *may* be a perforation, according to the sum of evidence you see (that is, the MRI scans combined with the subjective reportings of the patient)?
Whether yes or no, what is your best theory to account for the rapid loss of fluids from th intestine, given the initial 1.75 L volume is normally extremely sufficient? What other such "dynamic" could it be, if it is not the outright leakage into the areas outside of the organ?
(From a personal standpoint, I know with 100.00% full, complete certainty that this is what Ive been experiencing.)
Important Q: Is all visible air in the scan located within the small bowels? Or is any of it transferred to an area clearly outside of the small bowel boundaries?
Thank you for your time and dedication Doc!
-Jon
I do agree with your finding that fluid is in fact exiting the intestines. Besides my own subjective reporting of the sensations of fluid leaving the intestine, it is also radiologically suspicious to see that, according to the official report, most of my smal bowel segments were collapsed after drinking 1.75 L of pineapple juice, while most studies show that 1.00 L of pneapple juice is sufficient to keep all bowel segments distended in all subjects tested.
This does, in fact, imply strongly that the fluid has, in fact, left the bowel.
Only one of two things may be happening to it: (1) the fluid is more rapidly absorbed into the system, more rapidly than in any other normal patient; however, there is no evidence to support that this would be the case for me.
(2) the fluid has left the bowels via a non-inflamed, hidden perforation, and has MIXED IN with the peritoneal fluids of the peritoneum, which results in a composite fluid of serous fluid mixed with pineapple juice. This has been my subjective perception f what has been going on, and has been consistently been reported for about a year. It is therefore no coincidence that we see findings involving *fluids escaping from the small bowels*, from a patient who makes it clear that he has been experiencing fluids leaving his small bowels.
Doctor, please tell me--with the conclusion now reached that fluids do seem to be leaving the small bowels in a highly-unusual manner, what conclusion may we be able to reach by implication?
Are you able to make the implicit or presumptive diagnosis or medical opinion that there *may* be a perforation, according to the sum of evidence you see (that is, the MRI scans combined with the subjective reportings of the patient)?
Whether yes or no, what is your best theory to account for the rapid loss of fluids from th intestine, given the initial 1.75 L volume is normally extremely sufficient? What other such "dynamic" could it be, if it is not the outright leakage into the areas outside of the organ?
(From a personal standpoint, I know with 100.00% full, complete certainty that this is what Ive been experiencing.)
Important Q: Is all visible air in the scan located within the small bowels? Or is any of it transferred to an area clearly outside of the small bowel boundaries?
Thank you for your time and dedication Doc!
-Jon
As far as I am aware, the main source of air within the small bowels was introduced by myself intentionally, which is air that I swallowed along with the pineapple juice during consumption just prior to the MRI scan, done intentionally with the purpose of providing any radiologist with the opportunity to examine whether any percentage of this air was able to leave the small bowel via any hidden, small or masked perforations there, and flow out into the general inter-organ / peritoneal space.
I do agree with your finding that fluid is in fact exiting the intestines. Besides my own subjective reporting of the sensations of fluid leaving the intestine, it is also radiologically suspicious to see that, according to the official report, most of my smal bowel segments were collapsed after drinking 1.75 L of pineapple juice, while most studies show that 1.00 L of pneapple juice is sufficient to keep all bowel segments distended in all subjects tested.
This does, in fact, imply strongly that the fluid has, in fact, left the bowel.
Only one of two things may be happening to it: (1) the fluid is more rapidly absorbed into the system, more rapidly than in any other normal patient; however, there is no evidence to support that this would be the case for me.
(2) the fluid has left the bowels via a non-inflamed, hidden perforation, and has MIXED IN with the peritoneal fluids of the peritoneum, which results in a composite fluid of serous fluid mixed with pineapple juice. This has been my subjective perception f what has been going on, and has been consistently been reported for about a year. It is therefore no coincidence that we see findings involving *fluids escaping from the small bowels*, from a patient who makes it clear that he has been experiencing fluids leaving his small bowels.
Doctor, please tell me--with the conclusion now reached that fluids do seem to be leaving the small bowels in a highly-unusual manner, what conclusion may we be able to reach by implication?
Are you able to make the implicit or presumptive diagnosis or medical opinion that there *may* be a perforation, according to the sum of evidence you see (that is, the MRI scans combined with the subjective reportings of the patient)?
Whether yes or no, what is your best theory to account for the rapid loss of fluids from th intestine, given the initial 1.75 L volume is normally extremely sufficient? What other such "dynamic" could it be, if it is not the outright leakage into the areas outside of the organ?
(From a personal standpoint, I know with 100.00% full, complete certainty that this is what Ive been experiencing.)
Important Q: Is all visible air in the scan located within the small bowels? Or is any of it transferred to an area clearly outside of the small bowel boundaries?
Thank you for your time and dedication Doc!
-Jon
I do agree with your finding that fluid is in fact exiting the intestines. Besides my own subjective reporting of the sensations of fluid leaving the intestine, it is also radiologically suspicious to see that, according to the official report, most of my smal bowel segments were collapsed after drinking 1.75 L of pineapple juice, while most studies show that 1.00 L of pneapple juice is sufficient to keep all bowel segments distended in all subjects tested.
This does, in fact, imply strongly that the fluid has, in fact, left the bowel.
Only one of two things may be happening to it: (1) the fluid is more rapidly absorbed into the system, more rapidly than in any other normal patient; however, there is no evidence to support that this would be the case for me.
(2) the fluid has left the bowels via a non-inflamed, hidden perforation, and has MIXED IN with the peritoneal fluids of the peritoneum, which results in a composite fluid of serous fluid mixed with pineapple juice. This has been my subjective perception f what has been going on, and has been consistently been reported for about a year. It is therefore no coincidence that we see findings involving *fluids escaping from the small bowels*, from a patient who makes it clear that he has been experiencing fluids leaving his small bowels.
Doctor, please tell me--with the conclusion now reached that fluids do seem to be leaving the small bowels in a highly-unusual manner, what conclusion may we be able to reach by implication?
Are you able to make the implicit or presumptive diagnosis or medical opinion that there *may* be a perforation, according to the sum of evidence you see (that is, the MRI scans combined with the subjective reportings of the patient)?
Whether yes or no, what is your best theory to account for the rapid loss of fluids from th intestine, given the initial 1.75 L volume is normally extremely sufficient? What other such "dynamic" could it be, if it is not the outright leakage into the areas outside of the organ?
(From a personal standpoint, I know with 100.00% full, complete certainty that this is what Ive been experiencing.)
Important Q: Is all visible air in the scan located within the small bowels? Or is any of it transferred to an area clearly outside of the small bowel boundaries?
Thank you for your time and dedication Doc!
-Jon
Also, to ask further Q:
(1) We notice that the pineapple juice gives off a higher strength of signal from the image, which manifest as a kind of quality of increased brightness and highlighting. This is apparent on certain images, such as perhaps T2 images, even T1, and/or others as well.
Normally, such an increase of signal strength and image brightness would only come from the bowel's boundaries, as anything absorbed would be diluted, dispersed, metabolized in the liver, and not appear to be as strongly signalled or highlighted in any other surrounding tissues or volumes. However, when looking at some of these images, it seems that the peritoneum has retained a suspiciously high degree of signal strength, which cannot be explained by any other means. On some cross section, the peritoneum seems rich with strong signal contrast, presented by excessive brightness.
Are you able to make any such findings that are consistent with this (nonprofessional, untrained) perception of mine?
And,
(2) If this MRI test is not sensitive enough to perceive the perforation and related dynamics, what other kinds of tests might you recommend?
Would a live, upright MRI cine be useful, in recording where the pineapple juice is going? I can usually feel most cold fluids pool at the perineum and pelvic floor within several seconds.
Might a peritoneal fluid analysis also be helpful? If so, what distinct result or measure of the analysis would show "proof," beyond any doubt?
Thank you.
(1) We notice that the pineapple juice gives off a higher strength of signal from the image, which manifest as a kind of quality of increased brightness and highlighting. This is apparent on certain images, such as perhaps T2 images, even T1, and/or others as well.
Normally, such an increase of signal strength and image brightness would only come from the bowel's boundaries, as anything absorbed would be diluted, dispersed, metabolized in the liver, and not appear to be as strongly signalled or highlighted in any other surrounding tissues or volumes. However, when looking at some of these images, it seems that the peritoneum has retained a suspiciously high degree of signal strength, which cannot be explained by any other means. On some cross section, the peritoneum seems rich with strong signal contrast, presented by excessive brightness.
Are you able to make any such findings that are consistent with this (nonprofessional, untrained) perception of mine?
And,
(2) If this MRI test is not sensitive enough to perceive the perforation and related dynamics, what other kinds of tests might you recommend?
Would a live, upright MRI cine be useful, in recording where the pineapple juice is going? I can usually feel most cold fluids pool at the perineum and pelvic floor within several seconds.
Might a peritoneal fluid analysis also be helpful? If so, what distinct result or measure of the analysis would show "proof," beyond any doubt?
Thank you.
Also, to ask further Q:
(1) We notice that the pineapple juice gives off a higher strength of signal from the image, which manifest as a kind of quality of increased brightness and highlighting. This is apparent on certain images, such as perhaps T2 images, even T1, and/or others as well.
Normally, such an increase of signal strength and image brightness would only come from the bowel's boundaries, as anything absorbed would be diluted, dispersed, metabolized in the liver, and not appear to be as strongly signalled or highlighted in any other surrounding tissues or volumes. However, when looking at some of these images, it seems that the peritoneum has retained a suspiciously high degree of signal strength, which cannot be explained by any other means. On some cross section, the peritoneum seems rich with strong signal contrast, presented by excessive brightness.
Are you able to make any such findings that are consistent with this (nonprofessional, untrained) perception of mine?
And,
(2) If this MRI test is not sensitive enough to perceive the perforation and related dynamics, what other kinds of tests might you recommend?
Would a live, upright MRI cine be useful, in recording where the pineapple juice is going? I can usually feel most cold fluids pool at the perineum and pelvic floor within several seconds.
Might a peritoneal fluid analysis also be helpful? If so, what distinct result or measure of the analysis would show "proof," beyond any doubt?
Thank you.
(1) We notice that the pineapple juice gives off a higher strength of signal from the image, which manifest as a kind of quality of increased brightness and highlighting. This is apparent on certain images, such as perhaps T2 images, even T1, and/or others as well.
Normally, such an increase of signal strength and image brightness would only come from the bowel's boundaries, as anything absorbed would be diluted, dispersed, metabolized in the liver, and not appear to be as strongly signalled or highlighted in any other surrounding tissues or volumes. However, when looking at some of these images, it seems that the peritoneum has retained a suspiciously high degree of signal strength, which cannot be explained by any other means. On some cross section, the peritoneum seems rich with strong signal contrast, presented by excessive brightness.
Are you able to make any such findings that are consistent with this (nonprofessional, untrained) perception of mine?
And,
(2) If this MRI test is not sensitive enough to perceive the perforation and related dynamics, what other kinds of tests might you recommend?
Would a live, upright MRI cine be useful, in recording where the pineapple juice is going? I can usually feel most cold fluids pool at the perineum and pelvic floor within several seconds.
Might a peritoneal fluid analysis also be helpful? If so, what distinct result or measure of the analysis would show "proof," beyond any doubt?
Thank you.
Brief Answer:
Fluid might leave your bowels in traces through membranes
Detailed Answer:
Hi,
Thanks for writing back.
It is possible that fluid is escaping your bowel faster than normal. There is no large perforation to check but let us imagine that there is one or multiple tiny pores through which fluid might be escaping at 0.5 ml per second. In this way about 1800 ml can be lost in 2 hours and all the fluid can be made to leave the bowels. Ingesting air can make this faster.
So the fluid escaping will be trickling in drops and not a stream and this fluid is not collected in a puddle but can get spread over surfaces like the peritoneum and mesentry, within the vessels. So this can answer your question on the peritoneum taking in fluid.
There are sensitive tests like radio isotope imaging but that is a part of nuclear medicine and I am not well informed on the details of the testing.
Regards,
Fluid might leave your bowels in traces through membranes
Detailed Answer:
Hi,
Thanks for writing back.
It is possible that fluid is escaping your bowel faster than normal. There is no large perforation to check but let us imagine that there is one or multiple tiny pores through which fluid might be escaping at 0.5 ml per second. In this way about 1800 ml can be lost in 2 hours and all the fluid can be made to leave the bowels. Ingesting air can make this faster.
So the fluid escaping will be trickling in drops and not a stream and this fluid is not collected in a puddle but can get spread over surfaces like the peritoneum and mesentry, within the vessels. So this can answer your question on the peritoneum taking in fluid.
There are sensitive tests like radio isotope imaging but that is a part of nuclear medicine and I am not well informed on the details of the testing.
Regards,
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Fluid might leave your bowels in traces through membranes
Detailed Answer:
Hi,
Thanks for writing back.
It is possible that fluid is escaping your bowel faster than normal. There is no large perforation to check but let us imagine that there is one or multiple tiny pores through which fluid might be escaping at 0.5 ml per second. In this way about 1800 ml can be lost in 2 hours and all the fluid can be made to leave the bowels. Ingesting air can make this faster.
So the fluid escaping will be trickling in drops and not a stream and this fluid is not collected in a puddle but can get spread over surfaces like the peritoneum and mesentry, within the vessels. So this can answer your question on the peritoneum taking in fluid.
There are sensitive tests like radio isotope imaging but that is a part of nuclear medicine and I am not well informed on the details of the testing.
Regards,
Fluid might leave your bowels in traces through membranes
Detailed Answer:
Hi,
Thanks for writing back.
It is possible that fluid is escaping your bowel faster than normal. There is no large perforation to check but let us imagine that there is one or multiple tiny pores through which fluid might be escaping at 0.5 ml per second. In this way about 1800 ml can be lost in 2 hours and all the fluid can be made to leave the bowels. Ingesting air can make this faster.
So the fluid escaping will be trickling in drops and not a stream and this fluid is not collected in a puddle but can get spread over surfaces like the peritoneum and mesentry, within the vessels. So this can answer your question on the peritoneum taking in fluid.
There are sensitive tests like radio isotope imaging but that is a part of nuclear medicine and I am not well informed on the details of the testing.
Regards,
Above answer was peer-reviewed by :
Dr. Yogesh D
I have deeply considered the above, and in fact personally have come to the conclusion that it is, in fact, most likely the case that it is multiple small perforations.
Additionally, in the case of tiny perforations or pores, are we assuming that these are pores that are allowing for faster escape and absorption into systemic circulation and the general blood supply (ie., "leaky gut syndrome?")
Or, do we mean that these small pores or perforations are leading fluids out into the inter-organ space?
My own experience would support the latter being the case, just by the fact that I have been able to feel it.
In this case, if we acknowledge these tiny pores, then these fluids must be getting displaced somewhere. If this pineapple juice were to mix into the inter-organ space, what signs might we expect to see of this, in the absence of typical inflammatory reactions?
...
Anyway, I am going to examine soon a noncontrast MRI that I had taken for another abdominal (muscular) issue, to see if I can identify any difference in contrast signal strength, pursuant to what I had mentioned earlier.
Additionally: I would ask whether you would be able, as a doctor and radiologist, to make a supporting statement indicating, as part of your findings, the relative abnormality and unusual nature of the findings that 1.75 L of fluid having left my small bowels collapsed.
I shall write up a sample statement soon, and would ask whether you can make and support such a statement as a medical professional.
It will help me be able to bring more validity to my case within my own country. If my primary doctor sees that a radiologist, from anywhere, has seen something or makes a conclusion that something is not quite as it should be, then this can help secure further investigation.
Thank you.
Additionally, in the case of tiny perforations or pores, are we assuming that these are pores that are allowing for faster escape and absorption into systemic circulation and the general blood supply (ie., "leaky gut syndrome?")
Or, do we mean that these small pores or perforations are leading fluids out into the inter-organ space?
My own experience would support the latter being the case, just by the fact that I have been able to feel it.
In this case, if we acknowledge these tiny pores, then these fluids must be getting displaced somewhere. If this pineapple juice were to mix into the inter-organ space, what signs might we expect to see of this, in the absence of typical inflammatory reactions?
...
Anyway, I am going to examine soon a noncontrast MRI that I had taken for another abdominal (muscular) issue, to see if I can identify any difference in contrast signal strength, pursuant to what I had mentioned earlier.
Additionally: I would ask whether you would be able, as a doctor and radiologist, to make a supporting statement indicating, as part of your findings, the relative abnormality and unusual nature of the findings that 1.75 L of fluid having left my small bowels collapsed.
I shall write up a sample statement soon, and would ask whether you can make and support such a statement as a medical professional.
It will help me be able to bring more validity to my case within my own country. If my primary doctor sees that a radiologist, from anywhere, has seen something or makes a conclusion that something is not quite as it should be, then this can help secure further investigation.
Thank you.
I have deeply considered the above, and in fact personally have come to the conclusion that it is, in fact, most likely the case that it is multiple small perforations.
Additionally, in the case of tiny perforations or pores, are we assuming that these are pores that are allowing for faster escape and absorption into systemic circulation and the general blood supply (ie., "leaky gut syndrome?")
Or, do we mean that these small pores or perforations are leading fluids out into the inter-organ space?
My own experience would support the latter being the case, just by the fact that I have been able to feel it.
In this case, if we acknowledge these tiny pores, then these fluids must be getting displaced somewhere. If this pineapple juice were to mix into the inter-organ space, what signs might we expect to see of this, in the absence of typical inflammatory reactions?
...
Anyway, I am going to examine soon a noncontrast MRI that I had taken for another abdominal (muscular) issue, to see if I can identify any difference in contrast signal strength, pursuant to what I had mentioned earlier.
Additionally: I would ask whether you would be able, as a doctor and radiologist, to make a supporting statement indicating, as part of your findings, the relative abnormality and unusual nature of the findings that 1.75 L of fluid having left my small bowels collapsed.
I shall write up a sample statement soon, and would ask whether you can make and support such a statement as a medical professional.
It will help me be able to bring more validity to my case within my own country. If my primary doctor sees that a radiologist, from anywhere, has seen something or makes a conclusion that something is not quite as it should be, then this can help secure further investigation.
Thank you.
Additionally, in the case of tiny perforations or pores, are we assuming that these are pores that are allowing for faster escape and absorption into systemic circulation and the general blood supply (ie., "leaky gut syndrome?")
Or, do we mean that these small pores or perforations are leading fluids out into the inter-organ space?
My own experience would support the latter being the case, just by the fact that I have been able to feel it.
In this case, if we acknowledge these tiny pores, then these fluids must be getting displaced somewhere. If this pineapple juice were to mix into the inter-organ space, what signs might we expect to see of this, in the absence of typical inflammatory reactions?
...
Anyway, I am going to examine soon a noncontrast MRI that I had taken for another abdominal (muscular) issue, to see if I can identify any difference in contrast signal strength, pursuant to what I had mentioned earlier.
Additionally: I would ask whether you would be able, as a doctor and radiologist, to make a supporting statement indicating, as part of your findings, the relative abnormality and unusual nature of the findings that 1.75 L of fluid having left my small bowels collapsed.
I shall write up a sample statement soon, and would ask whether you can make and support such a statement as a medical professional.
It will help me be able to bring more validity to my case within my own country. If my primary doctor sees that a radiologist, from anywhere, has seen something or makes a conclusion that something is not quite as it should be, then this can help secure further investigation.
Thank you.
Brief Answer:
Regret that I am not authorised to issue any professional statement
Detailed Answer:
Hi,
Thanks for writing in.
I am looking forward to seeing the other MRI images that you have. We can try and get some information from the images.
I personally feel that you have somethign like a leaky gut syndroms and that can cause frequent pains and infections in the bowel in some individuals.
The flow of leaking fluids is in very minimal quantity but a good amount of fluid might leak over long periods of time.
I have consulted the authorities of Healthcaremagic.com regarding issuing a professional statement and they have said the following
" All the information, content and chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website".
Therefore it is regretted that I cannot issue a professional statement. However you may discuss the matter in greater detail with your primary doctors the potential leaky gut symptoms.
Regards,
Regret that I am not authorised to issue any professional statement
Detailed Answer:
Hi,
Thanks for writing in.
I am looking forward to seeing the other MRI images that you have. We can try and get some information from the images.
I personally feel that you have somethign like a leaky gut syndroms and that can cause frequent pains and infections in the bowel in some individuals.
The flow of leaking fluids is in very minimal quantity but a good amount of fluid might leak over long periods of time.
I have consulted the authorities of Healthcaremagic.com regarding issuing a professional statement and they have said the following
" All the information, content and chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website".
Therefore it is regretted that I cannot issue a professional statement. However you may discuss the matter in greater detail with your primary doctors the potential leaky gut symptoms.
Regards,
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Regret that I am not authorised to issue any professional statement
Detailed Answer:
Hi,
Thanks for writing in.
I am looking forward to seeing the other MRI images that you have. We can try and get some information from the images.
I personally feel that you have somethign like a leaky gut syndroms and that can cause frequent pains and infections in the bowel in some individuals.
The flow of leaking fluids is in very minimal quantity but a good amount of fluid might leak over long periods of time.
I have consulted the authorities of Healthcaremagic.com regarding issuing a professional statement and they have said the following
" All the information, content and chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website".
Therefore it is regretted that I cannot issue a professional statement. However you may discuss the matter in greater detail with your primary doctors the potential leaky gut symptoms.
Regards,
Regret that I am not authorised to issue any professional statement
Detailed Answer:
Hi,
Thanks for writing in.
I am looking forward to seeing the other MRI images that you have. We can try and get some information from the images.
I personally feel that you have somethign like a leaky gut syndroms and that can cause frequent pains and infections in the bowel in some individuals.
The flow of leaking fluids is in very minimal quantity but a good amount of fluid might leak over long periods of time.
I have consulted the authorities of Healthcaremagic.com regarding issuing a professional statement and they have said the following
" All the information, content and chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website".
Therefore it is regretted that I cannot issue a professional statement. However you may discuss the matter in greater detail with your primary doctors the potential leaky gut symptoms.
Regards,
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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