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What is the reason for my multiple problems?

Q: I am 34 years old and get typhoid quite frequently. Is there a cure for this or a vaccine? I got typhoid 15 years back, then 2 years later and from then on quite frequently for the past 7 years. I get frequent stomach and chest pain too. My recent ECG, treadmill, ultrasound of abdomen, x-ray KUB are all normal. I often feel a swelling in the stomach and also have gas problem. One of the doctors suggested that I may be having a hernia but several others examined and said maybe not. I get severe pain in the right side of the stomach if I do any heavy work. I have high BP so do not eat any outside food. My symptoms include: mild fever, stomach pain, whiteness of the tongue and then fever with body pains. Should I take ciprofloxacin continuously for one month? My hair has turned all grey. Please advise.

A:You have asked three different questions and I will address them individually: 1) Typhoid fever: it is unusual to get repeated attacks of typhoid. So the first question is whether you truly get typhoid infection or is it some other infection, which is mimicking typhoid. A typhoid vaccine will not help since you should have antibodies against typhoid if you definitely had typhoid infection. The vaccine is good for preventing typhoid infection in persons who have not previously had typhoid. The most important aspect of typhoid is to remember that individuals get this infection because they swallow the typhoid bacteria either through contaminated water or food. It is therefore important that you drink water that has been boiled and cooled, eat fruits that can be peeled such as a banana and avoid fruits like grapes unless you wash them very thoroughly in boiled and then cooled water. The food that you eat should be temperature hot and well cooked. If you follow the above recommendations you will avoid most food and water borne diseases of which typhoid is one. 2) Stomach and chest pain: the fact that all your tests are normal and that you are 34 years old makes it highly unlikely that you have any life-threatening chest or abdominal disease. Based on what you have told me I suspect that you have an irritable bowel or dyspepsia. These are both conditions, which can be troublesome to the patient but are not life-threatening. Please see a Gastroenterologist to see if he or she can help with these symptoms. 3) High blood pressure: while excessive salt in food can worsen your blood pressure. It is important that you have your blood pressure consistently below 140/90 mm Hg at rest. If it is not please see a physician who can prescribe or modify your medications to ensure that your blood pressure is normal.

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