A.As you point out, patients who’ve had surgery to remove their stomachs require vitamin B-12 shots to maintain adequate levels of this vitamin in their bodies. The reason is that the stomach normally produces a protein required for the absorption of B-12 from dietary sources.

Loss of this protein, due to removal of the stomach, leads to an inability of the digestive system to absorb B-12 in the last part of the small intestine, the ileum. Although the body stores about a three-year supply of B-12 in the liver, eventually this will get used up. B-12 deficiency can lead to anemia and neurologic dysfunction.

A.It is true that many preparations of various vitamins and minerals are available. These include certain nasal formulas and under-the-tongue (sublingual) lozenges. Although these may be adequate for vitamin supplementation in most people, these preparations would still not provide enough B-12 for someone who has had his or her stomach removed. This is because B-12 is not absorbed from the mouth or nose.

It is only absorbed in the ileum, as previously described, so B-12 from the supplements still requires the specific protein made by the stomach for absorption. At this time, the monthly B-12 shots are the recommended way to replete stores of this vitamin people who’ve had part of their stomach removed.

Tuberculosis Medications: In some men, the Epididymitis condition often comes from Tuberculosis, which means it may have to be treated with antituberculosis medications, including Rifampin, Pyrazinamide, and Isoniazid.

Decrease Swelling: To relieve pain and decrease the swelling, drugs such as aspirin or Ibuprofen, which are classified as non-steroidal anti-inflammatory drugs, or NSAIDS, may be required. In addition, the urologist may recommend a sitz bath or ice pack to help decrease the swelling.

Surgical Procedures: Based on how severe the degree of epididymitis and the causative condition, an individual may need one of several different types of surgeries. These surgical procedures may include an epididymectomy, an orchiectomy, an epididymotomy, or a scrotal exploration.

Supportive Treatment: In addition, decrease your physical activity, support the scrotum, and consider elevating it with soft padding or a small pillow. The use of analgesics, including Motrin, is also suggested to help relieve the pain.