Weight Loss and Diarrhea: Gastrointestinal Issues in Cancer Survivors

Q: Weight Loss and Diarrhea: Gastrointestinal Issues in Cancer Survivors

Hello Ms. Yali： 1. There is a low correlation with the liver, but regular ultrasound examinations (every 6 months) are still recommended. 2. It is advised to visit a gastroenterology clinic for stool tests and medication, and then consider a colonoscopy.

Diarrhea accompanied by weight loss?

Hello Dr.
Chen, I would like to consult you regarding my mother's health issues.
Here is a brief overview of her condition: My mother is 58 years old and has a history of breast cancer, for which she underwent bilateral mastectomy and has completed chemotherapy.
She is currently on medication for follow-up and her condition is relatively stable.
She has also had thyroid cancer, which has been surgically removed.

Regarding her liver health, she previously had a hepatitis B infection (currently has antibodies) and has also contracted hepatitis C due to a surgical infection, along with mild fatty liver disease.
Her liver function tests are still within normal limits.
Both of her parents passed away from liver cancer.

However, over the past three months, she has been experiencing abdominal pain after meals, leading to bowel movements that vary between normal (solid) and diarrhea (liquid).
This has resulted in a weight loss of about 6-7 kilograms (originally 63 kilograms).

Could this be irritable bowel syndrome, colon cancer, or related to her liver disease? What tests would you recommend, or which specialty should she consult? Thank you for taking the time to respond!

yali, 30~39 year old female. Ask Date: 2008/11/08

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello Ms.
Yali:
1.
There is a low correlation with the liver, but regular ultrasound examinations (every 6 months) are still recommended.

2.
It is advised to visit a gastroenterology clinic for stool tests and medication, and then consider a colonoscopy.

3.
Irritable bowel syndrome does not cause weight loss.
Changhua Hospital cares about your health.

Chen Shidian

Reply Date: 2008/11/08

More Info

Weight loss and diarrhea can be concerning symptoms, especially in a cancer survivor like your mother. Given her medical history, including breast cancer and thyroid cancer, as well as her liver issues, it is essential to approach her symptoms with a thorough understanding of potential underlying causes.

Firstly, the gastrointestinal symptoms your mother is experiencing—abdominal pain after meals, alternating between normal and watery stools, and significant weight loss—could indeed be indicative of several conditions. One possibility is Irritable Bowel Syndrome (IBS), which is characterized by abdominal discomfort and changes in bowel habits. However, given her cancer history, it is crucial to rule out more serious conditions, such as colorectal cancer or complications related to her liver disease.

The fact that she has lost 6-7 kg in three months is particularly concerning. Unintentional weight loss can be a red flag for malignancy, especially in someone with a history of cancer. While IBS can cause weight loss, it typically does not lead to such significant changes unless accompanied by severe dietary restrictions or malabsorption.
Additionally, her history of hepatitis B and C, along with a family history of liver cancer, raises the possibility that her liver condition could be contributing to her gastrointestinal symptoms. Liver disease can lead to various gastrointestinal manifestations, including diarrhea, due to bile salt malabsorption or changes in gut flora.
To address your concerns, I recommend the following steps:
1. Consult a Gastroenterologist: Given the complexity of her symptoms and medical history, a gastroenterologist would be best suited to evaluate her condition. They can perform a comprehensive assessment, including a detailed history and physical examination.

2. Diagnostic Tests: The gastroenterologist may recommend several tests, including:
- Colonoscopy: This is crucial to evaluate for any signs of colorectal cancer, especially given her weight loss and gastrointestinal symptoms.

- Upper Endoscopy (EGD): If her symptoms include upper abdominal pain or discomfort, this test can help visualize the esophagus, stomach, and duodenum.

- Imaging Studies: An abdominal ultrasound or CT scan can assess the liver and other abdominal organs for any abnormalities.

- Stool Tests: These can help identify infections, malabsorption issues, or inflammatory conditions.

3. Blood Tests: Comprehensive blood work, including liver function tests, complete blood count (CBC), and tumor markers (like CEA), may provide additional insights into her condition.

4. Dietary Assessment: A nutritionist can help evaluate her dietary intake and ensure she is receiving adequate nutrition, which is vital for her recovery and overall health.

5. Monitoring and Follow-Up: Close monitoring of her symptoms and regular follow-ups with her healthcare team will be essential to manage her condition effectively.

In conclusion, while her symptoms could be related to IBS or liver disease, the significant weight loss and her cancer history necessitate a thorough evaluation to rule out more serious conditions. Early detection and intervention are key in managing her health effectively. Please ensure she seeks medical attention promptly to address these concerning symptoms.

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