Bloating and Weight Loss: Signs of Possible Small Intestinal Issues

Q: Bloating and Weight Loss: Signs of Possible Small Intestinal Issues

Hello： If you had both an upper gastrointestinal endoscopy and a colonoscopy last year, have you had an abdominal ultrasound done? Small intestine cancer is extremely rare and does not even rank among the top fifteen cancers, so it is generally not considered in clinical practice

Recently, I have been experiencing persistent abdominal bloating and discomfort, along with weight loss?

Doctor, last month I started experiencing bloating and a feeling of heaviness in my abdomen.
Eventually, I couldn't tolerate it anymore and ended up vomiting after eating, which led to hospitalization.
The physician diagnosed me with acute gastritis.
They only performed an abdominal X-ray and mentioned that there was some gas in my small intestine (they explained that it's normal for a healthy person to have some gas in the small intestine and that they wouldn't immediately suspect a tumor, but they couldn't guarantee it either).
After being discharged, I was feeling somewhat better, but recently the symptoms seem to have returned.
I often feel heaviness and slight pain in my abdomen, along with bloating.
Sometimes it fluctuates, and it's most noticeable when I just wake up.
This week, my weight dropped from 76.3 kg to 75.5 kg (I've been eating normally, but I've reduced my intake of starchy foods in the evening and am eating slightly less overall).
I considered getting an endoscopy, but since I had one last September, the doctor wouldn't allow it.
I recently had an abdominal ultrasound, which showed nothing significant, and I had a colonoscopy last April, which was normal.
I have regular bowel movements, passing gas and having normal stool shape once a day.
My only concern is regarding my small intestine.
Could it be a tumor? Why would I have these symptoms for so long? I maintain a habit of exercising and controlling my diet, so why is this happening? What is the likelihood of small intestine cancer, doctor? Thank you for your response.

Luo Kai-Ren, 20~29 year old female. Ask Date: 2018/05/05

Dr. Chen Yunfang reply Oncology

Hello: If you had both an upper gastrointestinal endoscopy and a colonoscopy last year, have you had an abdominal ultrasound done? Small intestine cancer is extremely rare and does not even rank among the top fifteen cancers, so it is generally not considered in clinical practice.
If you are still feeling unwell, it is advisable to see a physician to differentiate between "anxiety" and "actual illness." A CT scan can determine the presence or absence of tumors, but it depends on whether the physician is willing to order it, as normal results can easily be flagged by health insurance for review, unless you choose to pay out of pocket, which typically costs around 5000 to 6000 NT dollars.
Thank you for your understanding!

Reply Date: 2018/05/05

More Info

Bloating and weight loss can indeed be concerning symptoms, particularly when they persist over time. In your case, the combination of abdominal bloating, discomfort, and weight loss raises several potential issues that warrant further investigation.
Firstly, it’s important to understand that the small intestine plays a crucial role in digestion and nutrient absorption. If there are problems in this area, such as inflammation, infection, or obstruction, it can lead to symptoms like bloating and weight loss. Given your history of acute gastritis and the recent findings of gas in the small intestine, it’s possible that you may be experiencing a functional gastrointestinal disorder, such as irritable bowel syndrome (IBS) or small intestinal bacterial overgrowth (SIBO). Both conditions can cause bloating and discomfort, and they can also affect your appetite and eating habits, potentially leading to weight loss.

The fact that you have experienced significant weight loss (from 76.3 kg to 75.5 kg) over a short period, despite normal eating habits, is concerning. Weight loss can be a sign of malabsorption, which occurs when the small intestine is unable to absorb nutrients effectively. This could be due to various reasons, including celiac disease, Crohn's disease, or other inflammatory conditions. Your mention of a previous endoscopy and colonoscopy, which showed no significant findings, is reassuring but does not completely rule out small intestinal issues.

Additionally, the symptoms you describe—bloating, discomfort, and changes in bowel habits—could also be indicative of a more serious condition, such as a tumor or other structural abnormalities in the small intestine. While the likelihood of small intestinal cancer is relatively low, especially in younger individuals without significant risk factors, it is not impossible. The presence of persistent symptoms, especially in conjunction with weight loss, should prompt further evaluation.

Given your concerns, it would be prudent to discuss the possibility of additional diagnostic tests with your physician. While you mentioned that your doctor is hesitant to perform another endoscopy, there are other options available, such as imaging studies (like a CT scan or MRI) or specialized tests for malabsorption (like a hydrogen breath test for SIBO). These tests can provide more insight into the function of your small intestine and help identify any underlying issues.

In the meantime, it’s essential to maintain a balanced diet and stay hydrated. Keeping a food diary may also help identify any specific triggers that exacerbate your symptoms. If you notice that certain foods consistently lead to bloating or discomfort, it may be beneficial to eliminate them from your diet temporarily.

Lastly, consider discussing your symptoms with a gastroenterologist, who specializes in digestive disorders. They can provide a more comprehensive evaluation and tailor a treatment plan based on your specific needs. Remember, early intervention is key in managing gastrointestinal issues effectively, so don’t hesitate to seek further medical advice.

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