Q: How important is it to see a doctor if you have diarrhea, nausea or vomiting? A: “If you have [persistent] nausea or vomiting, low CD4 counts would make you especially concerned about potentially life-threatening infections. In patients with more intact immune systems, you might be more concerned about non-infectious causes such as gastroparesis (delayed gastric emptying), chronic gastritis (damage to the lining of the stomach) or medication side effects.
Bottom line is that in any patient you want to figure out what is causing the symptom(s) and not just treat symptomatically with anti-nausea medications. If any symptoms persist more than a day or two I want the patient to let me know because those patients are often not taking in sufficient fluids and can become quickly dehydrated.” —Michael Wohlfeiler, MD, Mercy Hospital, Miami, Florida
Q: What kinds of questions should my doctor ask me before I start HIV meds? A: “The University of Pennsylvania study (page 2) suggests the need for careful history-taking to ascertain whether patients have had a history of gastric problems before they go on meds, particularly if PIs are to be prescribed.” –Benjamin Young, MD , Rose Medical Center, Denver, CO