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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Gut concerns
Jul 29, 2007

I am a 33 year old positive male with a CD4 of 287/15% and a VL of 8300 and am not on any HIV medications. I've been HIV+ for about 7-8 years but am otherwise healthy. I have been having severe stomach aches (not pains) virtually every evening (never in the day time) for the last couple of years. A feeling of extreme stomach bloating and ache right under the ribs that goes through to the back with a feeling of needing to burp but not beling able to. Usually symptoms also include constipation and a feeling of extreme hunger. Sleeping is not possible due to the discomfort which lasts for 2 - 10 hours typically. Colonoscopies, ultrasounds, scans, upper GI's and barium enemas have failed to identify anything other than a high level of lymph tissue in the GI tract. Is this a HIV issue or something GI specific? What are my doctors and I missing and what can I do to ease the nightly discomfort?

Response from Dr. Conway

At this stage, it is important to realize that the doctors have excluded a number of important conditions, such as cancer or a serious chronic infection. I would assume that they have checked for H. Pylori (the bacteria that causes ulcers or gastritis), as this is easy to diagnose and treat. Beyond this, some parasitic infections are hard to diagnose and empiric treatment for one or more of them might be something to try. Beyond this, the use of some medications to just control the symptoms (such as antacids or proton pump inhibitors) might give us an idea of what is the root cause of the problem and how it may be addressed.

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