Severe Constipation and Weight Loss: A Gastrointestinal Concern

Decreased appetite and weight loss along with severe constipation?

I have been experiencing severe bloating for an unknown period, which has led to frequent abdominal pain.
I went to the hospital for an examination and ultrasound, and the doctor prescribed medication for bloating.
After taking the medication, the issue was resolved.
However, since the bloating started, my appetite has significantly decreased.
Even now that the bloating has subsided, I still eat very little.
For example, I used to comfortably eat a McDonald's fish sandwich with fries and a drink, but now I can only eat about half of the fish sandwich before feeling extremely full.
Initially, I thought it might be due to indigestion, but even after slowing down my eating pace (taking about 25 minutes to eat one rice ball), there was no improvement.
My food intake has decreased so much that my weight dropped from 41 kg to 36.8 kg in just one month (from May 7 to June 16).
I weigh myself every morning, and I lose about 0.1 to 0.3 kg daily.
Additionally, I have always had infrequent bowel movements, but now I only go every 5 to 7 days, and the amount is very small.
I usually go to bed around midnight and drink about 1500 ml of water daily (I am 150 cm tall and weigh as mentioned).
My typical meals consist of breakfast with eggs or bread (usually only eating about a quarter of a piece), lunch varies but always includes carbohydrates (bread, rice balls, noodles, etc.), and for dinner, I often skip rice due to lack of appetite and only eat side dishes.
I am wondering if there are any effective ways to address my constipation issue.
Currently, I rely on probiotics and yogurt, but they don't seem to help much.
I have also tried various online remedies for constipation, but they have not worked either.
I am starting to think that my reduced food intake might be the reason for my lack of bowel movements, but going 7 days without a bowel movement seems excessive.
Furthermore, since the onset of my constipation, my menstrual period has also been absent for over a month, which seems abnormal.
What could be the underlying issue? What solutions are available? I have important exams coming up next year, but I often have to take leave due to abdominal pain, and this situation is really not sustainable for my third year of junior high.

Zhi Ning, 10~19 year old female. Ask Date: 2023/06/16

Dr. Chen Shidian reply Gastroenterology and Hepatology

It is recommended to consult a pediatrician or a pediatric gastroenterologist.

Reply Date: 2023/06/16

More Info

Severe constipation and significant weight loss can be concerning symptoms that warrant a thorough evaluation. Based on your description, it seems that you have experienced a series of gastrointestinal issues, including severe bloating, decreased appetite, and infrequent bowel movements. These symptoms can be interconnected and may indicate underlying gastrointestinal dysfunction.

Firstly, the bloating you experienced could have been a result of various factors, including dietary choices, food intolerances, or gastrointestinal motility issues. The fact that your bloating improved with anti-gas medication suggests that gas accumulation was a significant contributor to your discomfort. However, the subsequent decrease in appetite and drastic weight loss is concerning and requires further investigation.

Your current weight of 36.8 kg at a height of 150 cm indicates that you may be underweight, which can have serious health implications. Weight loss of approximately 4.2 kg in just over a month is significant and could be attributed to several factors, including malabsorption, decreased caloric intake due to early satiety, or even psychological factors such as stress or anxiety related to your upcoming exams.

The infrequent bowel movements, occurring every 5 to 7 days, suggest constipation, which can be exacerbated by a low food intake. When the body consumes fewer calories, there may be less waste to eliminate, leading to infrequent bowel movements. However, going such a long time without a bowel movement is not typical and can lead to further complications, such as fecal impaction.

Your mention of a missed menstrual period is also noteworthy. Amenorrhea (the absence of menstruation) can occur due to significant weight loss, stress, or hormonal imbalances, and it is essential to address this with a healthcare provider.

To address your constipation, consider the following recommendations:
1. Increase Fiber Intake: Gradually incorporate more fiber-rich foods into your diet, such as fruits, vegetables, whole grains, and legumes. Fiber helps to bulk up stool and promotes regular bowel movements.

2. Stay Hydrated: Ensure you are drinking enough fluids throughout the day. Aim for at least 1.5 to 2 liters of water daily, as hydration is crucial for digestive health.

3. Regular Meal Schedule: Try to establish a regular eating schedule. Eating smaller, more frequent meals may help stimulate your digestive system and promote bowel movements.

4. Physical Activity: Engage in regular physical activity, as exercise can help stimulate bowel function. Even light activities like walking can be beneficial.

5. Probiotics: While you mentioned using probiotics and yogurt, ensure you are consuming a variety of probiotic-rich foods or consider a high-quality probiotic supplement that contains multiple strains of beneficial bacteria.

6. Consult a Healthcare Provider: Given the severity of your symptoms, it is crucial to consult a healthcare provider for a comprehensive evaluation. They may recommend tests to rule out conditions such as gastrointestinal obstruction, malabsorption syndromes, or hormonal imbalances.

7. Mental Health Support: If you are experiencing stress or anxiety related to your exams or health, consider seeking support from a mental health professional. Stress can significantly impact gastrointestinal function.

In summary, your symptoms of severe constipation, weight loss, and missed menstrual periods are concerning and should be addressed promptly. A healthcare provider can help determine the underlying causes and develop an appropriate treatment plan tailored to your needs. It is essential to prioritize your health, especially as you prepare for your exams.

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