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Suggest Treatment For Diarrhea, Erectile Dysfunction And Shortness Of Breath

Posted on Sun, 19 Apr 2015

Question: I have been experiencing the following for almost a year: diarrhea, erectile dysfunction, high eosinophile in blood test(CBC), high IgE and shortness of breath.

What can be the possible cause?

Answered by Dr. Swarnava Dattagupta (2 hours later)

Brief Answer:
HYPER IgE SYNDROME or PARASITE INFECTION

Detailed Answer:
Hello.
Welcome to HCM.
This is Dr. Swarnava Dattagupta answering your query.

First of all, erectile dysfunction seems not be associated with the other symptoms. You can try drugs like sildenafil, tadalafil etc for that. Improvement should occur. Also do jelqing method and penis suction pump can be tried if the above does not give good response.
Now for the increased eosinophil count, increased IgE and associated diarrhea, these seems most likely to be because of chronic parasite infection. But other causes like HyperIgE syndrome, SLE, eosinophilic gastroenteritis, eosinophilic esophagitis, some drug reactions and even malignancies can lead to the above symptoms. It is important to rule out the common causes before diagnosis can be stamped. I will suggest you the following-
Take tab albendazole 1tab now and another after a month.
Take tab fexofenadine once daily for 15 days.
Talk to your doctor for its prescription.
Also you need a proper examination and few investigations to come to a diagnosis. Consult your physician for that.

Hope I have answered your question.
Contact me for further queries.
Regards

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Swarnava Dattagupta (10 hours later)

The increase in eosinophil had been detected in APR 2014 during my annual health check-up( about 6% differential count) and I had taken 2 tabs of albendazole in APR 2014 in an interval of 15 days. After a brief decrease, it went up to 21% in MAY 2014 and again I had taken 2 tabs of albendazole in JUN 2014. It did spike don to 11% next day after taking the first tab and went up to 20% in a day or two and similarly, after after taking the second tab it fell to 17% but XXXXXXX again. The doctor then had ruled out parasite presence.

Incidentally, I experienced ED for the first time in my life in APR 2014 after taking the two albendazole, which had improved substantially. But, again in JUN 2014 after taking albendazole the ED was most severe. I do not know whether it was a result of drug reaction or purely coincidental.

One thing which may also be pertinent is that I have urticaea (hives) which keep coming and going. This has been there for a long time - 20 years or so.

The hemoglobin level is consistent at 14 during entire last year. LFT, KFT are also ok. One hemangioma (12 mm size) was detected in my liver during medical checkup in APR 2014 and it was confirmed so after ultrasound followed by MRI with contrast. Also, there has been no perceptible weight loss.

Regarding gastrointestinal eosinophil, i would like to know:
(i) does it occur due to food allergy ?
(ii) is there any cure ?
(iii) what is the conclusive test for its confirmation/rejection ?

Thanks.

Answered by Dr. Swarnava Dattagupta (1 hour later)

Brief Answer:
INFORMATION ABOUT GASTROINTESTINAL EOSINOPHILIA

Detailed Answer:
Hello again.
Its good to know the detailed history.
Let me answer your questions one by one.

1. Yes, gastrointestinal eosinophilia though a rare disease can occur due to some food allergy. Hence an allergy test is advised which can help one avoiding to food one is allergic to.

2. Yes, cure is definitely possible though recurrence is common and a prolonged treatment s needed. Steroids and antiallergic drugs like montelukast, zafirlukast etc are given. Also specific foods are asked to be avoided.

3. The confirmatory test is endoscopic biopsy of the affected deeper layers of intestine or stomach and finding unusual histological eosinophilic infiltration.

Hope this was useful.
Wish you good health.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Swarnava Dattagupta (6 hours later)

Thanks for an accurate answer.

My last follow-up question is as under:

(i) what is an allergy test, blood test or skin test or observation in response to a particular food or article? where can it be done?

(ii) Is there any other indicator or test other than biopsy for GI eosinophil ?

(iii) Any comments on shortness of breath, esp. during sleep ?

Answered by Dr. Swarnava Dattagupta (1 hour later)

Brief Answer:
ALLERGY TESTS AND GI EOSINOPHILIA

Detailed Answer:
Hello again.
Let me answer your questions one by one again.

1. See allergy tests are basically skin tests which are some chemical disc like things applied over skin and foods and drugs are tested for any reactions to skin through them. It is done in many centres across XXXXXXX Check with your doctor about your locality.

2. Biopsy is diagnostic. Anyways blood tests for eosinophil count and serum IgE levels are also increased which you have already checked. Others are nonspecific.

3. Shortness during sleep can be due to heart problems, asthma or other chronic respiratory diseases and maybe sleep apnoea etc in obese patients. But proper examination and investigations are required before I can comment further.

Regards.
Wish you good health.

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj