Loss of Appetite: Insights for Busy Professionals - Gastroenterology and Hepatology

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Loss of appetite


Hello Dr.
Tsai, I am a busy working professional who has been drinking alcohol for many years.
For the past six months, I have been experiencing a loss of appetite, and alcohol has become difficult to consume.
I often feel nauseous, and around noon, I experience continuous rumbling in my lower right abdomen, with sounds so loud that I feel the need to cover my ears.
My weight has dropped significantly (currently at 42.5 kg).
Additionally, I have issues with lumbar disc displacement, heart discomfort, hypertension, insomnia, and I suffer from pain.
I feel weak and exhausted every day, and it seems like I am barely surviving.
However, I am also concerned about causing distress to my loved ones, and when I seek medical help, I find that different doctors provide varying opinions, which may not address my symptoms effectively.
I am located in Keelung and have seen various specialists who have only prescribed painkillers and sleeping aids.
I would greatly appreciate it if you could spare some time to guide me or refer me to a good doctor.
Thank you very much.

si ke, 40~49 year old female. Ask Date: 2006/08/10

Dr. Cai Yaozhou reply Gastroenterology and Hepatology


The term "appetite" refers to the physiological need to eat.
When this need diminishes or even disappears, it is referred to as loss of appetite.
Simply put, it means a lack of desire to eat.
So, who is more likely to experience loss of appetite? Generally, office workers may experience temporary loss of appetite due to fatigue or mental stress, which is considered a relatively mild phenomenon.
Additionally, overeating, excessive drinking, insufficient physical activity, and chronic constipation can also contribute to loss of appetite.
However, it is important to be aware of some underlying issues, such as unexplained loss of appetite or persistent loss of appetite.

Loss of appetite is often directly associated with gastrointestinal problems, such as chronic gastritis, gastroparesis, and gastric cancer, all of which may present with such symptoms.
Early symptoms of liver disease can also trigger long-term loss of appetite.
In fact, loss of appetite caused by liver disease is often extreme, and in severe cases, there may be a complete lack of appetite.
Friends and family of the patient can easily notice the patient's severe aversion to food.
Furthermore, conditions such as kidney disease, hypothyroidism, infectious diseases like dysentery and cholera, as well as heart disease and brain tumors, can also lead to loss of appetite.

For women, early pregnancy and the side effects of oral contraceptives may also result in loss of appetite or nausea.
Some believe that individuals with mental illnesses also experience loss of appetite.
For example, patients with depression may show a lack of interest in their surroundings and be unable to focus on basic physiological needs, instead concentrating on negative or distressing thoughts.
Anorexia nervosa may lead individuals to want to maintain a slim figure, resulting in significant weight loss due to refusal to eat.
Patients with schizophrenia may avoid food due to delusions of food being poisoned, or they may exhibit catatonic behavior, remaining fixated or in a fixed posture, showing little interest in external food.
Therefore, if you notice that you or someone close to you is experiencing loss of appetite, you can try using foods with strong aromas, spicy flavors, or bitter tastes to stimulate gastric secretion and enhance appetite.
If appetite does not improve, it is best to seek medical evaluation.

Reply Date: 2006/08/10

More Info


Loss of appetite can be a complex issue, particularly for busy professionals who may be juggling multiple responsibilities and stressors. Your situation, characterized by a significant decrease in appetite, nausea, and weight loss, is concerning and warrants a thorough evaluation.
Firstly, it's important to recognize that loss of appetite can stem from various physical and psychological factors. Given your history of alcohol consumption, it’s crucial to consider the potential impact of alcohol on your gastrointestinal system and overall health. Chronic alcohol use can lead to gastritis, liver disease, and other gastrointestinal issues, which may contribute to your symptoms of nausea and loss of appetite. Additionally, alcohol can interfere with the absorption of essential nutrients, leading to malnutrition, which could explain your significant weight loss.

You mentioned experiencing right lower abdominal sounds and discomfort, which could indicate gastrointestinal distress. Conditions such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), or even issues related to your lumbar disc displacement could be contributing to your symptoms. It’s essential to consult a gastroenterologist who can perform appropriate tests, such as imaging studies or endoscopy, to evaluate your gastrointestinal health.

Moreover, your reported symptoms of fatigue, insomnia, and heart discomfort may suggest an underlying anxiety or depressive disorder. Stress and mental health issues can significantly affect appetite and overall well-being. It might be beneficial to consult a mental health professional who can help you explore these aspects and provide coping strategies or therapies that could improve your emotional health and, consequently, your appetite.

Given your high blood pressure and the pain you are experiencing, it is crucial to manage these conditions effectively. Medications for hypertension and pain relief should be monitored closely by a healthcare provider to ensure they are not contributing to your loss of appetite or other symptoms.
In terms of seeking medical help, it may be helpful to find a primary care physician who can coordinate your care and refer you to specialists as needed. A comprehensive approach that includes a thorough medical history, physical examination, and possibly lab tests will help identify the root causes of your symptoms.
Additionally, consider lifestyle modifications that may improve your appetite and overall health. Eating small, frequent meals rather than three large ones can sometimes help stimulate appetite. Incorporating nutrient-dense foods that are easy to digest may also be beneficial. Staying hydrated is essential, especially if you are experiencing nausea.
Lastly, if you feel overwhelmed by the healthcare system or have had negative experiences with previous providers, it might be worth seeking recommendations from trusted friends or family for a physician who is attentive and understanding.
In summary, your loss of appetite and associated symptoms are serious and should not be ignored. A multidisciplinary approach involving a primary care physician, a gastroenterologist, and a mental health professional may provide the best chance for recovery and improvement in your quality of life. Please prioritize seeking medical attention to address these concerning symptoms.

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