Unexplained Weight Loss and Digestive Issues

Q: Unexplained Weight Loss and Digestive Issues

Hello： It is recommended that you visit the Department of Metabolism and the Department of Gastroenterology at a medical center to determine the cause of your condition. <br>Thank you for your message!

Annoying physical discomfort?

Hello Doctor: Since the end of September last year, my weight has dropped from 68 kg to 52 kg.
My height is 172 cm, and my condition includes a sudden decrease in appetite, lack of desire to eat, discomfort, nausea, and dizziness.
I often experience nausea or dizziness, usually after meals or in the morning upon waking.
The symptoms fluctuate and do not always occur immediately after eating; they may arise two hours post-meal.
During severe episodes, I have experienced vomiting and an inability to eat throughout the day.
Sometimes, even drinking water makes me feel uncomfortable.
In January of this year, I underwent an endoscopy, which revealed mild gastritis but no other issues.
The doctor confirmed there was no Helicobacter pylori infection and prescribed medication to reduce stomach acid.
However, my condition did not improve.
Later, the doctor suggested it might be a psychological issue, so I consulted a psychologist in March, but no psychological stress or problems were identified.
Recently, my weight has started to drop again, from 55 kg to 52 kg.
The doctor mentioned it could be a problem with indigestion, but after taking the medication for a month, my condition did not improve; instead, it worsened (with increased vomiting and diarrhea).
When I returned to the doctor a week later, he immediately discontinued the medication and performed a gastroscopy and abdominal CT scan, which did not reveal any physical issues.
My most recent blood test also showed normal results.
Before this illness, I had a very large appetite and loved going to the gym.
Currently, I often feel weak and uncomfortable, and I still feel nauseous after eating (with a desire to vomit).
My appetite remains small (whereas I could eat ten portions before, now I can only eat three to four).
Could you please advise me on which specialist I should consult for further examination?

Ke Xiansheng, 20~29 year old female. Ask Date: 2014/06/18

Dr. Xie Rongyuan reply Internal Medicine

Hello: It is recommended that you visit the Department of Metabolism and the Department of Gastroenterology at a medical center to determine the cause of your condition.
Thank you for your message!

Reply Date: 2014/06/18

More Info

It sounds like you are experiencing a complex set of symptoms that have led to significant weight loss and digestive issues. Your situation is concerning, and it’s important to approach it with a comprehensive understanding of potential underlying causes. Given your symptoms of loss of appetite, nausea, dizziness, and significant weight loss from 68 kg to 52 kg, there are several areas to consider.

Firstly, it’s crucial to rule out any serious medical conditions that could be contributing to your symptoms. Since you have already undergone an endoscopy and imaging studies (CT scan) that did not reveal any significant abnormalities, it may be time to explore other avenues. Here are some potential areas to consider:
1. Gastroenterology: Since you have a history of gastric inflammation and ongoing digestive issues, a gastroenterologist can further evaluate your gastrointestinal tract. They may consider additional tests such as a gastric emptying study to assess how well your stomach is processing food, or tests for food intolerances or allergies that could be causing your symptoms.

2. Endocrinology: Hormonal imbalances can significantly affect appetite and metabolism. Conditions such as hyperthyroidism or adrenal insufficiency can lead to weight loss and gastrointestinal symptoms. An endocrinologist can perform blood tests to evaluate your thyroid function and other hormonal levels.

3. Psychiatry/Psychology: While you mentioned that a psychological evaluation did not reveal any stressors, it may be worth revisiting this area. Conditions such as depression or anxiety can manifest physically, affecting appetite and digestion. A mental health professional can help explore any underlying emotional factors that may not have been fully addressed.

4. Nutrition: Consulting with a registered dietitian can be beneficial. They can help you develop a meal plan that accommodates your reduced appetite while ensuring you receive adequate nutrition. They may also provide strategies to manage nausea and improve your overall eating experience.

5. Neurology: Given your symptoms of dizziness and nausea, a neurologist may be able to assess whether there are any neurological issues contributing to your symptoms. Conditions affecting the vestibular system, which controls balance, could potentially explain your dizziness.

6. Infectious Disease: If there is any suspicion of an underlying infection that has not been identified, an infectious disease specialist may be able to conduct further testing.

In addition to seeking specialized care, it’s important to monitor your symptoms closely. Keeping a detailed diary of your food intake, symptoms, and any triggers can provide valuable information to your healthcare providers. This can help them identify patterns and potential causes of your symptoms.

Lastly, it’s essential to prioritize your health and well-being. If you are feeling weak or unwell, ensure you are staying hydrated and consider small, frequent meals that are easier to digest. Foods that are bland and low in fat may help reduce nausea.
In summary, your situation requires a multidisciplinary approach. Engaging with specialists in gastroenterology, endocrinology, nutrition, and possibly neurology or psychiatry will provide a comprehensive evaluation of your symptoms. It’s important to advocate for your health and ensure that all potential causes are explored thoroughly.

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