hey dr bob, hows it going? hope all is well.

I have a question relating to candida. Basically I have been suffering from esophagitis (feeling of something stuck in the throat) it varies in severity, but passive cigarette smoke is unfortunately a huge aggravator! At the same time I have also had thrush for 2 years, yeast overgrowth that also seems to affect the surrounding crotch area. I have been to the GUM clinic and they gave me medication but this hasn't cured the problem. I am aware that HIV sufferes do have problems with candiasis. It just seems bizarre that the problems I have just discussed all kick in very soon after a traumatic potential exposure, and never let up since. The point I'm trying to make is that it is very hard to put HIV fears to bed when I have had these conditions affecting me for nearly 3 years now. After potential exposure i had a bad cold about a week later and esophagitis and thrush set in immediately after and have never ceased. However, considering my negative HIV tests to 6 months there doesnt seem to be any other reasonable explanation. I have been to various doctors (3 in all) and sent to hospital (to have had a camera up my nose to look down my throat!)but none of this has led to a successful diagnosis or alleviation of symptoms.Also been to various councillors to deal with the trauma of my potential exposure and the aftermath(wont go into detail). Not sure what else I can do apart from hope that these symptoms subside! I know you state that a negative result is conclusive after 3 months (I have tested out to 6!), and that councilling and consulting doctors are the best way forward for people still worrying but I have done all these things, but these symptoms are still dragging me down! I know you cant diagnose over the internet, but I feel a bit better just for discussing my situation with you as I have asked for your advice before and you have been extremely helpful with your responses in the past (helped me through some tough times). So if anything, I would just like to end this with a heart felt thankyou to yourself

Hi,

I agree you are having a very difficult time putting your HIV fears permanently to rest. However, I remain convinced your problem is just that: fears, not HIV!

In addition, I doubt you've had thrush for three years unresponsive to medications and without an identifiable underlying cause. To prove my point, you could consult an infectious disease specialist or ENT physician. Thrush just doesn't behave that way without a readily identifiable cause! As for "esophagitis," I tend to doubt that diagnosis as well. The "feeling of something stuck in the throat" when there isn't anything there (as conclusively proven by your camera-through-the-nose-and-down-the-throat procedure!) is a classic symptom of anxiety called "globus hystericus." It's fairly common and produces very real symptoms and bouts of choking.

Your repeatedly negative HIV tests out to six months are definitive and conclusive. HIV is not your problem. No way. No how. No additional HIV tests are warranted.

You are correct: I cannot diagnose conditions over the Internet. However, I'm very confident what you need is a psychiatrist (not just a "counselor"). Psychiatric help really is your road back to both physical and psychological well-being. Bring a copy of this post and my response to your first visit and share it with the psychiatrist. It will help focus your treatment and speed your recovery.

Good luck! Remember, HIV is not your problem, OK?

Dr. Bob