Nausea and Loss of Appetite: When to Seek Medical Help

Q: Nausea and Loss of Appetite: When to Seek Medical Help

Dear Ms. 751： 1. Please consult the physician you saw last year for "weight loss due to nausea and loss of appetite" before making any decisions. 2. Generally, when encountering patients with nausea and loss of appetite, physicians will consider infectious

Nausea and loss of appetite?

Hello, doctor.
Last year, I experienced nausea and loss of appetite, which led to weight loss.
After seeing a doctor, my condition improved slightly.
However, two weeks ago, I suddenly felt nauseous while eating, accompanied by a rapid heartbeat and cold sweats.
This occurs two to three times a week, and I also tend to feel nauseous when I'm anxious.
After these episodes, I have no appetite for the entire day.
If I want to seek medical attention, which specialty should I consult? Is there a need for an endoscopy?

751, 20~29 year old female. Ask Date: 2023/05/08

Dr. Xiao Yongxun reply Family Medicine

Dear Ms.
751:
1.
Please consult the physician you saw last year for "weight loss due to nausea and loss of appetite" before making any decisions.

2.
Generally, when encountering patients with nausea and loss of appetite, physicians will consider infectious diseases, gastrointestinal disorders, central nervous system diseases, endocrine and metabolic issues, drug or toxin-related problems, as well as other conditions such as glaucoma, heart disease, pregnancy, cyclic vomiting syndrome, and radiation therapy, among others.
If the cause cannot be identified, laboratory tests, imaging studies, endoscopic examinations, or other relevant tests should be conducted to determine the underlying issue.
However, it is also important to consider mental health disorders such as depression, anxiety, binge eating disorder, and anorexia nervosa.

3.
There are numerous clinical examinations available, some of which are invasive or time-consuming.
The selection of tests should be based on the clinician's assessment of the patient's history and physical examination findings.

Reply Date: 2023/05/08

More Info

Nausea and loss of appetite can be distressing symptoms that may indicate various underlying health issues. Given your experience of sudden nausea accompanied by increased heart rate and cold sweats, along with a significant loss of appetite, it is essential to approach this situation with caution and seek appropriate medical advice.

When to Seek Medical Help
You should consider seeking medical help if you experience any of the following:
1. Persistent Symptoms: If nausea and loss of appetite persist for more than a few days or worsen over time.

2. Severe Symptoms: If you experience severe abdominal pain, vomiting, or if you notice blood in your vomit or stool.

3. Dehydration Signs: If you are unable to keep fluids down, leading to signs of dehydration such as dry mouth, dizziness, or decreased urination.

4. Weight Loss: If you have experienced significant weight loss (more than 5% of your body weight) over a short period.

5. Accompanying Symptoms: If nausea is accompanied by symptoms such as fever, jaundice (yellowing of the skin or eyes), or changes in mental status.

Which Specialist to See
Given your symptoms, you should consider seeing a gastroenterologist, a specialist who deals with disorders of the digestive system. They can evaluate your symptoms in the context of gastrointestinal health and may recommend further testing.

Diagnostic Tests
Regarding the need for an endoscopy (gastroscopy), it depends on your specific symptoms and the findings during your initial consultation. A gastroenterologist may recommend this procedure if:
- They suspect an underlying condition such as gastritis, ulcers, or other gastrointestinal disorders.

- Your symptoms suggest potential complications that need direct visualization of the upper gastrointestinal tract.

Other Considerations
1. Anxiety and Stress: Since you mentioned that nausea occurs when you are nervous, it may be beneficial to explore whether anxiety is contributing to your symptoms. Stress and anxiety can lead to gastrointestinal symptoms, including nausea and appetite changes. A mental health professional may provide strategies to manage anxiety effectively.

2. Dietary Factors: Keep a food diary to track what you eat and any associated symptoms. This information can help your healthcare provider identify potential food intolerances or allergies.

3. Medication Review: If you are taking any medications, discuss them with your doctor, as some medications can cause nausea and appetite loss as side effects.

4. Lifestyle Modifications: Consider small, frequent meals rather than large ones, and focus on bland foods that are easier to digest. Staying hydrated is also crucial.

Conclusion
In summary, while nausea and loss of appetite can stem from various causes, your symptoms warrant a thorough evaluation by a gastroenterologist. They can help determine the underlying cause and recommend appropriate treatment. If your symptoms are severe or worsening, do not hesitate to seek immediate medical attention. Remember, early intervention can lead to better outcomes and improved quality of life.

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