> I actually gave this guy different advice a few years ago on Slashdot.

I can't tell one anonymous poster from another.

> At the time, I told him to go to the most prestigious academic medical center in his area and not to trust the average primary care doctors.

What changed your mind ?

> So I assume he's done that already.

How can you be sure ? How do you know for sure it is the same person ?

> How else do you explain 18 years of going to doctor after doctor without any improvement.

Mis-diagnosis. Possibly unresponsive to treatment.

Mistakes can and do happen.

> Suppose he'd instead said that he'd been to astrologer after astrologer and found no improvement, in spite of the recent realization of the placement of Mars. You'd probably not tell him to keep trying to find an astrological explanation... so why are you so confident that there is a medical explanation right around the corner?

Because each and every of his symptoms ties in with at least two fairly common and very serious conditions that are in spite of being so common routinely mis-diagnosed and/or mistreated.

> The body has incredible ability to heal itself.

Right, let's use the power of our minds to heal. Some guy not personally known to you comes with a veritable laundry list of symptoms and instead of sticking to tried and true medicine you want him to practice yoga.

> By following my advice (after 18 years of following yours) he may actually stumble upon some information that helps lead toward a solution.

Or he may waste 3 more months on a trajectory that seems to be deteriorating to the point that he's asking total strangers for help. Not that we're going to be able to give him concrete advice, only a very qualified doctor could do that. But instead you advise him to get away from it all.

> - Maybe he gets no exercise at present because he uses what energy he has for work.

> - Maybe he has a rare food sensitivity. If so, eating the diet I suggested may make it much better or much worse. In either case he gains information.

It may be, or it may not be. But changing so many variables at once is never going to give him information, you do that by keeping a diary and slow variation over time so you can isolate a cause.

> - Going to a relaxing place (CR has the happiest population in the world) will help alleviate all the existential stress he's taken on after 18 years of dealing with this illness.

That's great, and I'm sure the Tourist Board of Costa Rica approves of your message. But that's not medical advice.

> My suggestions are based on big picture lifestyle approaches that actually do work. Medicine does not even remotely consider suggesting such a therapy because most people could never actually follow it. I predict that if you could do a study where people followed the therapy I proposed you'd find it was more effective than many of the most lauded pharmaceuticals and surgical techniques in use today for a variety of ailments.

Poppycock. Surgery and medication when needed are effective ways of dealing with a large variety of ailments, and good lifestyle can help you avoid those for a long time.

Lots of people die on an annual basis because of following the well meant advice of quacks that have little knowledge and too much self confidence.

Red flag right there "Medicine does not even remotely consider suggesting such a therapy because most people could never actually follow it", if a change in life style was all that is needed to treat Chron's, Lyme's and a whole pile of other serious diseases you can bet that plenty of people would be following it.

I'm not saying that there are no individuals that would not benefit from changing their lifestyle, but we can't all live in Costa Rica and even some of those that could follow it might end up seriously dead if their conditions are not treated by an application of medical knowledge.

> There is also the chance that this guy has some exceptionally rare condition that is not even known/understood by medical science. If so my advice would be to just enjoy life as much as possible rather than become a human lab rat.

Then say that, and qualify it.