Abdominal Pain and Weight Loss: A Surgical Perspective

The physician would like to seek your professional advice?

Hello Doctor: Recently, I have been experiencing dull pain on both sides of my abdomen, sometimes accompanied by referred pain.
I previously underwent an examination that revealed intestinal gas pockets.
I have been self-monitoring for about three months, and I have noticed that my stool appears orange-red (when wiping).
I use both squat and sitting toilets, and when I flush, the water immediately turns a deep brown color.
I would like to ask if this could indicate the presence of occult blood.
Additionally, I have not intentionally lost weight; I weighed 65.8 kg during a health check in early June, but by the end of July, my weight had dropped to 62.7 kg.
Is this considered rapid weight loss? The reason for my health check is that I am a professional soldier, which requires regular examinations.
I also experience feelings of nausea and have a poor appetite, especially when consuming meat, which exacerbates the nausea.
These are the concerns I have, and I would appreciate your help in clarifying these issues so that I can feel more at ease.
Thank you!

cotiao, 40~49 year old female. Ask Date: 2016/08/02

Dr. Chen Jiaming reply Surgery

Given the history of diverticular disease, abdominal pain should be carefully evaluated for symptoms of diverticulitis (such as persistent worsening pain or fever).
If you notice orange-red stains on toilet paper after wiping, this is likely fresh blood, which is typically due to mucosal damage at the anal area or bleeding from external hemorrhoids.
Occult blood refers to blood that is not visible to the naked eye and is generally used to detect blood components left in the stool by intestinal tumors.
Weight changes can vary significantly from person to person and depend on lifestyle; it is common to lose a few kilograms due to slightly warmer weather or mild dehydration.
There are many factors that can influence feelings of nausea and poor appetite.
In summary, if you are concerned about colorectal cancer, which is diagnosed in approximately 17,000 people annually in Taiwan, it is strongly recommended to undergo a formal colonoscopy with a gastroenterologist or colorectal surgeon.
This can address many of your concerns, as each of your symptoms can serve as an indication for examination.
If polyps are found (considered a source of cancer), they can be addressed early to reduce the likelihood of future occurrences.

Reply Date: 2016/08/02

More Info

When it comes to abdominal pain and unintentional weight loss, especially in the context of a military professional, it is essential to approach the situation with a comprehensive understanding of potential underlying issues. Your symptoms, including the dull pain on both sides of your abdomen, changes in stool color, and the significant weight loss, warrant careful evaluation.

Firstly, the abdominal pain you are experiencing could be indicative of several conditions. The "pulling" sensation you describe may suggest issues related to the gastrointestinal tract, such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even gallbladder-related issues, especially given your mention of changes in stool color. The orange-red color of your stool could be a result of dietary factors, but it may also indicate the presence of blood, particularly if you notice a change in the consistency or if it is accompanied by other symptoms like pain or discomfort. The deep coffee color of the water after flushing may suggest the presence of blood in your stool, which is a concerning symptom that should be evaluated by a healthcare professional.

Regarding your weight loss, a drop from 65.8 kg to 62.7 kg over a few months, especially without intentional dieting, is considered significant and could be classified as rapid weight loss. This can be alarming, as unintentional weight loss can be a sign of various medical conditions, including metabolic disorders, malignancies, gastrointestinal issues, or chronic infections. Given your profession as a military personnel, stress and lifestyle factors may also contribute to changes in appetite and weight.

The nausea and decreased appetite, particularly with meat, further complicate the picture. These symptoms could be related to gastrointestinal disturbances, such as gastritis or peptic ulcers, which can cause discomfort and aversion to certain foods. Additionally, psychological factors, including stress or anxiety, can also manifest as gastrointestinal symptoms and changes in eating habits.

In light of these symptoms, it is crucial to seek a thorough evaluation from a healthcare provider. A gastroenterologist would be well-suited to investigate these issues further. They may recommend diagnostic tests such as blood work, stool tests, imaging studies (like an abdominal ultrasound or CT scan), or even an endoscopy to assess the gastrointestinal tract directly.

It is also important to monitor your symptoms closely. If you experience any worsening of abdominal pain, changes in bowel habits, or additional symptoms such as fever, vomiting, or severe fatigue, you should seek immediate medical attention.

In summary, your symptoms of abdominal pain, changes in stool color, and unintentional weight loss are concerning and should be evaluated by a medical professional. A comprehensive approach, including a detailed medical history, physical examination, and appropriate diagnostic testing, will be essential in determining the underlying cause of your symptoms and guiding effective treatment. Please prioritize your health and seek the necessary medical care to address these issues.

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